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Walker SC, Ahrens KR, Owens MD, Parnes M, Langley J, Ackerley C, Purtle J, Saldana L, Aarons GA, Hogue A, Palinkas LA. Using policy codesign to achieve multi-sector alignment in adolescent behavioral health: a study protocol. Implement Sci Commun 2024; 5:54. [PMID: 38720398 PMCID: PMC11077850 DOI: 10.1186/s43058-024-00583-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/06/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Policymaking is quickly gaining focus in the field of implementation science as a potential opportunity for aligning cross-sector systems and introducing incentives to promote population health, including substance use disorders (SUD) and their prevention in adolescents. Policymakers are seen as holding the necessary levers for realigning service infrastructure to more rapidly and effectively address adolescent behavioral health across the continuum of need (prevention through crisis care, mental health, and SUD) and in multiple locations (schools, primary care, community settings). The difficulty of aligning policy intent, policy design, and successful policy implementation is a well-known challenge in the broader public policy and public administration literature that also affects local behavioral health policymaking. This study will examine a blended approach of coproduction and codesign (i.e., Policy Codesign), iteratively developed over multiple years to address problems in policy formation that often lead to poor implementation outcomes. The current study evaluates this scalable approach using reproducible measures to grow the knowledge base in this field of study. METHODS This is a single-arm, longitudinal, staggered implementation study to examine the acceptability and short-term impacts of Policy Codesign in resolving critical challenges in behavioral health policy formation. The aims are to (1) examine the acceptability, feasibility, and reach of Policy Codesign within two geographically distinct counties in Washington state, USA; (2) examine the impact of Policy Codesign on multisector policy development within these counties using social network analysis; and (3) assess the perceived replicability of Policy Codesign among leaders and other staff of policy-oriented state behavioral health intermediary organizations across the USA. DISCUSSION This study will assess the feasibility of a specific approach to collaborative policy development, Policy Codesign, in two diverse regions. Results will inform a subsequent multi-state study measuring the impact and effectiveness of this approach for achieving multi-sector and evidence informed policy development in adolescent SUD prevention and treatment.
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Affiliation(s)
- Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA.
| | - Kym R Ahrens
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA
| | - Mandy D Owens
- Addictions, Drug & Alcohol Institute, University of Washington, Seattle, WA, USA
| | - McKenna Parnes
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA
| | - Joe Langley
- Lab For Living, Sheffield Hallam University, Sheffield, UK
| | - Christine Ackerley
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Jonathan Purtle
- Department of Public Health Policy and Management, Global Center for Implementation Science, New York University, New York City, USA
| | - Lisa Saldana
- Chestnut Health Systems, Lighthouse Institute, Eugene, OR, USA
| | - Gregory A Aarons
- Department of Psychiatry, UC San Diego ACTRI Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA
| | - Aaron Hogue
- Partnership to End Addiction, New York, NY, USA
| | - Lawrence A Palinkas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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Jeong CH, Oh H, Palinkas LA, Lusenhop W. Perceptions of Health Insurance Among Self-employed Korean Immigrants From South Korea in the United States. Health Educ Behav 2024; 51:167-175. [PMID: 36495118 DOI: 10.1177/10901981221139169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Korean Americans in the United States are more likely than other Asian ethnic groups to lack health insurance despite their high education and economic prosperity. According to the model of health service selection, immigrants' perceptions of the health care system and health care behaviors in their host country are affected by sociocultural referents including premigration health care experience in the country of origin. This study explored Korean immigrants' perceptions of health insurance and their intentions to purchase and maintain health insurance in the United States. We conducted in-depth interviews with 24 self-employed Korean immigrants who migrated from South Korea and were living in the Greater Los Angeles area in 2015. Participants generally had negative perceptions of U.S. health insurance in terms of cost, benefits, simplicity, and accessibility. Coupled with their positive experiences with the single-payer, universal health insurance in South Korea, respondents evaluated U.S. health insurance as not worth purchasing, and indicated they would not maintain health insurance once the individual mandate of the Affordable Care Act was abolished. On the contrary, respondents who immigrated prior to the establishment of the Korean universal health insurance in South Korea were relatively satisfied with U.S. health insurance and had maintained health insurance for substantial periods of time. Korean immigrants' premigration health care experiences appeared to influence their decisions to purchase health insurance in the United States and their intention to maintain health insurance. The study findings highlight the necessity of tailored health education that takes into account sociocultural determinants of health coverage among immigrants.
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Perrigo JL, Molina AP, López O, Traube D, Palinkas LA. The deinstitutionalization of children and adolescents in El Salvador's child protection system. Child Abuse Negl 2024; 147:106601. [PMID: 38113572 DOI: 10.1016/j.chiabu.2023.106601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/29/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND In 2010, El Salvador introduced legislation aimed at reforming the country's Child Protective System (CPS), with a focus on promoting deinstitutionalization. OBJECTIVE The study aim was to explore the impact of deinstitutionalization on the Salvadoran CPS. PARTICIPANTS AND SETTING The study was conducted in El Salvador, granting authors unique access to key informants with extensive experience in the country's CPS. Unlike the United States, which is divided into states, El Salvador is divided into departments, and CPS providers were recruited from all 14 departments. Focus groups were facilitated in the East, West, and Central zones to ensure representation from all regions. METHODS Qualitative semi-structured interviews (n = 26) were conducted in June/July of 2019, which were then followed by focus groups (n = 4) in August 2019. The analysis of the data employed a combination of deductive and inductive thematic coding methods. RESULTS CPS providers offered valuable insights, categorized into five main themes: (1) Strengths of El Salvador's CPS, (2) Deinstitutionalization policy encompassing socioenvironmental contextual factors, (3) Challenges in the deinstitutionalization process, including insufficient follow-up on deinstitutionalized children, (4) Recommendations from participants, highlighting the importance of enhancing stakeholder coordination/collaboration, and (5) The necessity for a paradigm shift, emphasizing the need to redefine the social contract on protecting children from child maltreatment. CONCLUSIONS The Salvadoran CPS requires substantial systemic changes. Encouragingly, key informants have demonstrated a commitment to reform not only the deinstitutionalization process but also the broader CPS system in El Salvador including case management and quality of care in institutional settings.
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Affiliation(s)
- Judith L Perrigo
- University of California, Los Angeles (UCLA), Luskin School of Public Affairs, Social Welfare Department, 3250 Public Affairs Building, Los Angeles, CA 90095-1656, USA.
| | | | - Omar López
- University of Southern California (USC), Suzanne Dworak-Peck School of Social Work, 669 W 34(th) Street, Los Angeles, CA 90089, USA
| | - Dorian Traube
- University of Southern California (USC), Suzanne Dworak-Peck School of Social Work, 669 W 34(th) Street, Los Angeles, CA 90089, USA
| | - Lawrence A Palinkas
- University of Southern California (USC), Suzanne Dworak-Peck School of Social Work, 669 W 34(th) Street, Los Angeles, CA 90089, USA
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Eisman AB, Whitman J, Palinkas LA, Fridline J, Harvey C, Kilbourne AM, Hutton DW. A mixed methods partner-focused cost and budget impact analysis to deploy implementation strategies for school-based prevention. Implement Sci Commun 2023; 4:133. [PMID: 37946235 PMCID: PMC10636820 DOI: 10.1186/s43058-023-00511-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Obtaining information on implementation strategy costs and local budget impacts from multiple perspectives is essential to data-driven decision-making about resource allocation for successful evidence-based intervention delivery. This mixed methods study determines the costs and priorities of deploying Enhanced Replicating Effective Programs (REP) to implement the Michigan Model for Health™, a universal school-based prevention intervention, from key shareholder perspectives. METHODS Our study included teachers in 8 high schools across 3 Michigan counties as part of a pilot cluster randomized trial. We used activity-based costing, mapping key Enhanced REP activities across implementation phases. We included multiple perspectives, including state agencies, regional education service agencies, lead organization, and implementers. We also conducted a budget impact analysis (BIA, assessing the potential financial impact of adopting Enhanced REP) and a scenario analysis to estimate replication and account for cost variability. We used an experimental embedded mixed methods approach, conducting semi-structured interviews and collecting field notes during the trial to expand and explain the cost data and the implications of costs across relevant perspectives. RESULTS Based on trial results, we estimate costs for deploying Enhanced REP are $11,903/school, with an estimated range between $8263/school and $15,201/school. We estimate that adding four additional schools, consistent with the pilot, would cost $8659/school. Qualitative results indicated misalignment in school and teacher priorities in some cases. Implementation activities, including training and implementation facilitation with the health coordinator, were sometimes in addition to regular teaching responsibilities. The extent to which this occurred was partly due to leadership priorities (e.g., sticking to the district PD schedule) and organizational priorities (e.g., budget). CONCLUSIONS Previous research findings indicate that, from a societal perspective, universal prevention is an excellent return on investment. However, notable misalignment in cost burden and priorities exists across shareholder groups. Our results indicate significant personal time costs by teachers when engaging in implementation strategy activities that impose an opportunity cost. Additional strategies are needed to improve the alignment of costs and benefits to enhance the success and sustainability of implementation. We focus on those perspectives informed by the analysis and discuss opportunities to expand a multi-level focus and create greater alignment across perspectives. TRIAL REGISTRATION ClinicalTrials.gov NCT04752189. Registered on 12 February 2021.
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Affiliation(s)
- Andria B Eisman
- Division of Kinesiology, Health, and Sport Studies, College of Education, Wayne State University, 2153 Faculty/Administration Building, 656 West Kirby Street, Detroit, MI, 48202, USA.
| | - Jacob Whitman
- Department of Economics, College of Liberal Arts, Wayne State University, 656 West Kirby Street, Detroit, MI, 48202, USA
| | - Lawrence A Palinkas
- School of Social Work, University of Southern California, 669 W 34th Street, Los Angeles, CA, 90089, USA
| | - Judy Fridline
- Genesee Intermediate School District, 2143 Maple Road, Flint, MI, 48507, USA
| | - Christina Harvey
- Oakland Intermediate School District, 2111 Pontiac Lake Road, Waterford Township, MI, 48328, USA
| | - Amy M Kilbourne
- VA Ann Arbor Healthcare System, North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Ann Arbor, MI, 48109, USA
| | - David W Hutton
- Department of Health Management and Policy, School of Public Health, University of Michigan, M3525 SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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Javier JR, Aguiling W, Cunanan P, Sepulveda A, Coffey DM, Castro J, Palinkas LA, Kipke MD, Mack WJ. Short-term outcomes from a pilot randomized controlled trial evaluating a virtual culturally adapted parenting intervention among Filipino parents of school-age children. Cultur Divers Ethnic Minor Psychol 2023:2024-18630-001. [PMID: 37856386 PMCID: PMC11026304 DOI: 10.1037/cdp0000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND Filipino youth in the United States have significant behavioral health problems, including high rates of depression and suicidal behavior. Evidence-based parenting groups promote positive parenting practices and improve child behavior, yet few have been implemented online. OBJECTIVES This study tested the short-term effects of a culturally adapted hybrid version of the Incredible Years School Age Basic and Advance Programs when delivered online among groups of parents of Filipino children and estimated intervention effect sizes. METHOD Forty-nine parents of children aged 8-12 years recruited from schools, clinics, community organizations, and social media were randomly assigned to intervention or a wait-list control group that received literature from the American Academy of Pediatrics' Bright Futures program. The intervention consisted of 12 weekly 2-hr sessions. Parent perceptions of child behavior, parenting practices, and parenting stress as well as child surveys of anxiety and depression symptoms using validated assessments were obtained at baseline and 3-month postintervention follow-up. RESULTS Forty parents completed both baseline and follow-up surveys with a mean attendance of 9.35 out of 12 sessions (n = 18). Analysis of covariance comparing 3-month (pre-/postintervention) changes revealed that the program had a statistically significant positive impact on parenting practices (positive verbal discipline, praise and incentives, and clear expectations); parent perceptions of their child's internalizing symptoms; and child-reported anxiety and depression symptoms. CONCLUSIONS Results support the feasibility and potential effectiveness of offering an online evidence-based parenting program to promote positive parenting and decrease child anxiety and depression. This multigenerational approach to mental health prevention could potentially help address the growing mental health epidemic among youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Lawrence A Palinkas
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | | | - Wendy J Mack
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
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Palinkas LA, Belanger R, Newton S, Saldana L, Landsverk J, Dubowitz H. Assessment of Adoption and Early Implementation Barriers and Facilitators of the Safe Environment for Every Kid (SEEK) Model. Acad Pediatr 2023; 23:1434-1445. [PMID: 37354951 PMCID: PMC10592284 DOI: 10.1016/j.acap.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE Although the use of interventions for screening for social determinants of health of families in pediatric primary care clinics has increased in the past decade, research on the barriers and facilitators of implementing such interventions has been limited. We explored barriers, facilitators, and the mechanisms clarifying their roles in the adoption and implementation of the Safe Environment for Every Kid (SEEK) model, an approach for strengthening families, promoting children's health and development, and preventing child maltreatment. METHODS A total of 28 semistructured interviews were completed with 9 practice champions, 11 primary care professionals, 5 behavioral health professionals, and 3 nursing/administrative staff representing 12 pediatric primary care practices participating in a larger randomized control trial of implementing SEEK. RESULTS We identified several barriers and facilitators in the stages of SEEK's adoption and early implementation. Barriers associated with outer and inner setting determinants and poor innovation-organization fit declined in importance over time, while facilitators associated with SEEK characteristics increased in importance based on participants' responses. Barriers and facilitators were linked by mechanisms of comparison and contrast of burdens and benefits, and problem-solving to address limited capacity with available resources. CONCLUSIONS Any screening for and addressing social determinants of health demands greater attention to adoption and implementation mechanisms and the processes by which primary care professionals assess and utilize facilitators to address barriers. This occurs in a context defined by perceived burdens and benefits of innovation adoption and implementation, the capacity of the practice, and changes in perception with experiencing the innovation.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work (LA Palinkas), University of Southern California, Los Angeles, Calif.
| | - Rosemarie Belanger
- Department of Pediatrics (R Belanger, S Newton, and H Dubowitz), University of Maryland School of Medicine, Baltimore, MD
| | - Stacey Newton
- Department of Pediatrics (R Belanger, S Newton, and H Dubowitz), University of Maryland School of Medicine, Baltimore, MD
| | - Lisa Saldana
- Oregon Social Learning Center (L Saldana and J Landsverk), Eugene, Ore
| | - John Landsverk
- Oregon Social Learning Center (L Saldana and J Landsverk), Eugene, Ore
| | - Howard Dubowitz
- Department of Pediatrics (R Belanger, S Newton, and H Dubowitz), University of Maryland School of Medicine, Baltimore, MD
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Garcia S, Shin M, Sloan K, Dang E, Garcia CO, Baezconde-Garbanati L, Palinkas LA, Crabtree BF, Tsui J. Disruptions to and Innovations in HPV Vaccination Strategies within Safety-Net Healthcare Settings Resulting from the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2380. [PMID: 37685414 PMCID: PMC10486876 DOI: 10.3390/healthcare11172380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic disrupted healthcare delivery within safety-net settings. Barriers to and facilitators of human papillomavirus (HPV) vaccination during the pandemic can inform future HPV vaccine strategies for underserved communities. Qualitative interviews (n = 52) between December 2020 and January 2022 in Los Angeles and New Jersey were conducted with providers, clinic leaders, clinic staff, advocates, payers, and policy-level representatives involved in the HPV vaccine process. Using the updated Consolidated Framework for Implementation Research we identified (1) outer setting barriers (i.e., vaccine hesitancy driven by social media, political views during the pandemic) and facilitators (e.g., partnerships); (2) inner setting clinic facilitators (i.e., motivation-driven clinic metrics, patient outreach, vaccine outreach events); (3) individual characteristics such as patient barriers (i.e., less likely to utilize clinic services during the pandemic and therefore, additional outreach to address missed vaccine doses are needed); (4) innovations in HPV vaccination strategies (i.e., clinic workflow changes to minimize exposure to COVID-19, leveraging new community partnerships (e.g., with local schools)); and (5) implementation strategies (i.e., multisectoral commitment to HPV goals). Pandemic setbacks forced safety-net settings to develop new vaccine approaches and partnerships that may translate to new implementation strategies for HPV vaccination within local contexts and communities.
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Affiliation(s)
- Samantha Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (S.G.); (K.S.); (E.D.); (C.O.G.); (L.B.-G.)
| | - Michelle Shin
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA 98195, USA;
| | - Kylie Sloan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (S.G.); (K.S.); (E.D.); (C.O.G.); (L.B.-G.)
| | - Emily Dang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (S.G.); (K.S.); (E.D.); (C.O.G.); (L.B.-G.)
| | - Carlos Orellana Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (S.G.); (K.S.); (E.D.); (C.O.G.); (L.B.-G.)
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (S.G.); (K.S.); (E.D.); (C.O.G.); (L.B.-G.)
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
| | - Lawrence A. Palinkas
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA;
| | - Benjamin F. Crabtree
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA;
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (S.G.); (K.S.); (E.D.); (C.O.G.); (L.B.-G.)
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
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Shin MB, Sloan K, Baezconde-Garbanati L, Dang E, Garcia S, Palinkas LA, Unger JB, Willgerodt M, Crabtree BF, Tsui J. Multilevel perspectives on school-based opportunities to improve HPV vaccination among medically underserved adolescents: Beyond school entry mandates. Hum Vaccin Immunother 2023; 19:2251815. [PMID: 37666253 PMCID: PMC10478734 DOI: 10.1080/21645515.2023.2251815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/12/2023] [Accepted: 08/01/2023] [Indexed: 09/06/2023] Open
Abstract
School-based HPV vaccination programs have improved vaccine uptake among adolescents globally. However, school-based HPV vaccination strategies in the United States (US) have mainly focused on school-entry mandates for vaccination, which have passed in only five states/jurisdictions. Many schools and school-based health centers (SBHCs) already provide health services to medically underserved adolescents and opportunities to improve disparities in HPV vaccine education and uptake are underexplored. This qualitative study of clinic and community members assessed potential opportunities within and outside schools to increase HPV vaccination. Data were generated from a larger mixed-methods study designed to understand experiences with HPV vaccination evidence-based strategies in medically underserved communities. The parent study included interviews and focus groups conducted with clinic (providers, clinic leaders, staff) and community (racial/ethnic minority parents, advocates, payers, policy representatives) members in Los Angeles and New Jersey between December 2020-January 2022. We created a reduced dataset of text related to schools/SBHCs (30 in-depth interviews, 7 focus groups) and conducted a directed content analysis. Participants indicated that schools and SBHCs are ideal venues for reaching medically underserved adolescents experiencing barriers to primary care access. Parents/providers expressed mutual interest in HPV vaccine administration/education in schools, but some advocates/policy participants experienced challenges due to increasing politicization of vaccines. Participants highlighted policies for expanding HPV vaccine education and administration in schools, including minor consent and increasing SBHC funding for HPV vaccines. More research is needed to explore existing infrastructure, partner motivation, and opportunities to improve HPV vaccination among medically underserved adolescents within schools beyond vaccine mandates.
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Affiliation(s)
- Michelle B. Shin
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WAUSA
| | - Kylie Sloan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Emily Dang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Samantha Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lawrence A. Palinkas
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Mayumi Willgerodt
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WAUSA
| | | | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
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Knight DK, Funk RR, Belenko S, Dennis M, Wiese AL, Bartkowski JP, Dembo R, Elkington KS, Flynn PM, Harris PW, Hogue A, Palinkas LA, Robertson AA, Scott CK. Results of a national survey of substance use treatment services for youth under community supervision. Health Justice 2023; 11:29. [PMID: 37515602 PMCID: PMC10385917 DOI: 10.1186/s40352-023-00233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Despite the heightened risk for substance use (SU) among youth in the juvenile justice system, many do not receive the treatment that they need. OBJECTIVES The purpose of this study is to examine the extent to which youth under community supervision by juvenile justice agencies receive community-based SU services and the factors associated with access to such services. METHODS Data are from a nationally representative sample of Community Supervision (CS) agencies and their primary behavioral health (BH) partners. Surveys were completed by 192 CS and 271 BH agencies. RESULTS SU services are more often available through BH than CS for all treatment modalities. EBPs are more likely to be used by BH than by CS. Co-location of services occurs most often in communities with fewer treatment options and is associated with higher interagency collaboration. Youth are more likely to receive services in communities with higher EBP use, which mediates the relationship between the availability of SU treatment modalities and the proportion of youth served. CONCLUSION Findings identify opportunities to strengthen community systems and improve linkage to care.
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Affiliation(s)
- Danica K Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA.
| | - Rod R Funk
- Chestnut Health Systems, 1003 Martin Luther King Jr. Drive, Bloomington, IL, 61701, USA
| | - Steven Belenko
- Temple University, 1801 N. Broad Street, Philadelphia, PA, 19122, USA
| | - Michael Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL, 61761, USA
| | - Amanda L Wiese
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA
| | - John P Bartkowski
- University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78248, USA
| | - Richard Dembo
- University of Southern Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA
| | - Katherine S Elkington
- Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA
| | - Philip W Harris
- Temple University, 1801 N. Broad Street, Philadelphia, PA, 19122, USA
| | - Aaron Hogue
- Partnership to End Addiction, Family and Adolescent Clinical Technology & Science (FACTS), 485 Lexington Avenue, 3rd Floor, New York, NY, 10017, USA
| | - Lawrence A Palinkas
- University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90089, USA
| | - Angela A Robertson
- Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS, 39759, USA
| | - Christy K Scott
- Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL, 60610, USA
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Tsui J, Shin M, Sloan K, Martinez B, Palinkas LA, Baezconde-Garbanati L, Cantor JC, Hudson SV, Crabtree BF. Understanding Clinic and Community Member Experiences with Implementation of Evidence-Based Strategies for HPV Vaccination in Safety-Net Primary Care Settings. Prev Sci 2023:10.1007/s11121-023-01568-4. [PMID: 37368117 DOI: 10.1007/s11121-023-01568-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 06/28/2023]
Abstract
HPV vaccination rates remain below target levels among adolescents in the United States, which is particularly concerning in safety-net populations with persistent disparities in HPV-associated cancer burden. Perspectives on evidence-based strategies (EBS) for HPV vaccination among key implementation participants, internal and external to clinics, can provide a better understanding of why these disparities persist. We conducted virtual interviews and focus groups, guided by the Practice Change Model, with clinic members (providers, clinic leaders, and clinic staff) and community members (advocates, parents, policy-level, and payers) in Los Angeles and New Jersey to understand common and divergent perspectives on and experiences with HPV vaccination in safety-net primary care settings. Fifty-eight interviews and seven focus groups were conducted (n = 65 total). Clinic members (clinic leaders n = 7, providers n = 12, and clinic staff n = 6) revealed conflicting HPV vaccine messaging, lack of shared motivation to reduce missed opportunities and improve workflows, and non-operability between clinic electronic health records and state immunization registries created barriers for implementing effective strategies. Community members (advocates n = 8, policy n = 11, payers n = 8, and parents n = 13) described lack of HPV vaccine prioritization among payers, a reliance on advocates to lead national agenda setting and facilitate local implementation, and opportunities to support and engage schools in HPV vaccine messaging and adolescents in HPV vaccine decision-making. Participants indicated the COVID-19 pandemic complicated prioritization of HPV vaccination but also created opportunities for change. These findings highlight design and selection criteria for identifying and implementing EBS (changing the intervention itself, or practice-level resources versus external motivators) that bring internal and external clinic partners together for targeted approaches that account for local needs in improving HPV vaccine uptake within safety-net settings.
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Affiliation(s)
- Jennifer Tsui
- University of Southern California, Los Angeles, CA, USA.
| | | | - Kylie Sloan
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Joel C Cantor
- Rutgers the State University of New Jersey, New Brunswick, NJ, USA
| | - Shawna V Hudson
- Rutgers the State University of New Jersey, New Brunswick, NJ, USA
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Palinkas LA, De Leon J, Yu K, Salinas E, Fernandez C, Johnston J, Rahman MM, Silva SJ, Hurlburt M, McConnell RS, Garcia E. Adaptation Resources and Responses to Wildfire Smoke and Other Forms of Air Pollution in Low-Income Urban Settings: A Mixed-Methods Study. Int J Environ Res Public Health 2023; 20:5393. [PMID: 37048007 PMCID: PMC10094253 DOI: 10.3390/ijerph20075393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 06/19/2023]
Abstract
Little is known about how low-income residents of urban communities engage their knowledge, attitudes, behaviors, and resources to mitigate the health impacts of wildfire smoke and other forms of air pollution. We interviewed 40 adults in Los Angeles, California, to explore their threat assessments of days of poor air quality, adaptation resources and behaviors, and the impacts of air pollution and wildfire smoke on physical and mental health. Participants resided in census tracts that were disproportionately burdened by air pollution and socioeconomic vulnerability. All participants reported experiencing days of poor air quality due primarily to wildfire smoke. Sixty percent received advanced warnings of days of poor air quality or routinely monitored air quality via cell phone apps or news broadcasts. Adaptation behaviors included remaining indoors, circulating indoor air, and wearing face masks when outdoors. Most (82.5%) of the participants reported some physical or mental health problem or symptom during days of poor air quality, but several indicated that symptom severity was mitigated by their adaptive behaviors. Although low-income residents perceive themselves to be at risk for the physical and mental health impacts of air pollution, they have also adapted to that risk with limited resources.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Jessenia De Leon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Kexin Yu
- Department of Neurology, Oregon Health Sciences University, Portland, OR 97239, USA
| | - Erika Salinas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Cecilia Fernandez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Md Mostafijur Rahman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Sam J. Silva
- Department of Earth Sciences, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Michael Hurlburt
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Rob S. McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
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Sloan K, Shin M, Palinkas LA, Hudson SV, Crabtree BF, Cantor JC, Tsui J. Exploring HPV vaccination policy and payer strategies for opportunities to improve uptake in safety-net settings. Front Public Health 2023; 11:1099552. [PMID: 37213634 PMCID: PMC10192548 DOI: 10.3389/fpubh.2023.1099552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction We explored priorities and perspectives on health policy and payer strategies for improving HPV vaccination rates in safety-net settings in the United States. Methods We conducted qualitative interviews with policy and payer representatives in the greater Los Angeles region and state of New Jersey between December 2020 and January 2022. Practice Change Model domains guided data collection, thematic analysis, and interpretation. Results Five themes emerged from interviews with 11 policy and 8 payer participants, including: (1) payer representatives not prioritizing HPV vaccination specifically in incentive-driven clinic metrics; (2) policy representatives noting region-specific HPV vaccine policy options; (3) inconsistent motivation across policy/payer groups to improve HPV vaccination; (4) targeting of HPV vaccination in quality improvement initiatives suggested across policy/payer groups; and (5) COVID-19 pandemic viewed as both barrier and opportunity for HPV vaccination improvement across policy/payer groups. Discussion Our findings indicate opportunities for incorporating policy and payer perspectives into HPV vaccine improvement processes. We identified a need to translate effective policy and payer strategies, such as pay-for-performance programs, to improve HPV vaccination within safety-net settings. COVID-19 vaccination strategies and community efforts create potential policy windows for expanding HPV vaccine awareness and access.
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Affiliation(s)
- Kylie Sloan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Michelle Shin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lawrence A. Palinkas
- Department of Children, Youth, and Families, Suzanne Dworak-Peck School of Social Work University of Southern California, Los Angeles, CA, United States
| | - Shawna V. Hudson
- Department of Family Medicine and Community Health, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Benjamin F. Crabtree
- Department of Family Medicine and Community Health, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Joel C. Cantor
- Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Jennifer Tsui
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Eisman AB, Palinkas LA, Koffkey C, Herrenkohl TI, Abbasi U, Fridline J, Lundahl L, Kilbourne AM. Michigan Model for HealthTM Learning to Enhance and Adapt for Prevention (Mi-LEAP): protocol of a pilot randomized trial comparing Enhanced Replicating Effective Programs versus standard implementation to deliver an evidence-based drug use prevention curriculum. Pilot Feasibility Stud 2022; 8:204. [PMID: 36088351 PMCID: PMC9463731 DOI: 10.1186/s40814-022-01145-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background School-based drug use prevention programs have demonstrated notable potential to reduce the onset and escalation of drug use, including among youth at risk of poor outcomes such as those exposed to trauma. Researchers have found a robust relationship between intervention fidelity and participant (i.e., student) outcomes. Effective implementation of evidence-based interventions, such as the Michigan Model for HealthTM (MMH), is critical to achieving desired public health objectives. Yet, a persistent gap remains in what we know works and how to effectively translate these findings into routine practice. The objective of this study is to design and test a multi-component implementation strategy to tailor MMH to meet population needs (i.e., students exposed to trauma), and improve the population-context fit to enhance fidelity and effectiveness. Methods Using a 2-group, mixed-method randomized controlled trial design, this study will compare standard implementation versus Enhanced Replicating Effective Programs (REP) to deliver MMH. REP is a theoretically based implementation strategy that promotes evidence-based intervention (EBI) fidelity through a combination of EBI curriculum packaging, training, and as-needed technical assistance and is consistent with standard MMH implementation. Enhanced REP will tailor the intervention and training to integrate trauma-informed approaches and deploy customized implementation support (i.e., facilitation). The research will address the following specific aims: (1) design and test an implementation strategy (Enhanced REP) to deliver the MMH versus standard implementation and evaluate feasibility, acceptability, and appropriateness using mixed methods, (2) estimate the costs and cost-effectiveness of Enhanced REP to deliver MMH versus standard implementation. Discussion This research will design and test a multi-component implementation strategy focused on enhancing the fit between the intervention and population needs while maintaining fidelity to MMH core functions. We focus on the feasibility of deploying the implementation strategy bundle and costing methods and preliminary information on cost input distributions. The substantive focus on youth at heightened risk of drug use and its consequences due to trauma exposure is significant because of the public health impact of prevention. Pilot studies of implementation strategies are underutilized and can provide vital information on designing and testing effective strategies by addressing potential design and methods uncertainties and the effects of the implementation strategy on implementation and student outcomes. Trial registration NCT04752189—registered on 8 February 2021 on ClinicalTrials.gov PRS
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Palinkas LA, Hurlburt MS, Fernandez C, De Leon J, Yu K, Salinas E, Garcia E, Johnston J, Rahman MM, Silva SJ, McConnell RS. Vulnerable, Resilient, or Both? A Qualitative Study of Adaptation Resources and Behaviors to Heat Waves and Health Outcomes of Low-Income Residents of Urban Heat Islands. Int J Environ Res Public Health 2022; 19:11090. [PMID: 36078804 PMCID: PMC9517765 DOI: 10.3390/ijerph191711090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/19/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
Little is known of how low-income residents of urban heat islands engage their knowledge, attitudes, behaviors, and resources to mitigate the health impacts of heat waves. In this qualitative study, we conducted semi-structured interviews with 40 adults in two such neighborhoods in Los Angeles California to explore their adaptation resources and behaviors, the impacts of heat waves on physical and mental health, and threat assessments of future heat waves. Eighty percent of participants received advanced warning of heat waves from television news and social media. The most common resource was air conditioning (AC) units or fans. However, one-third of participants lacked AC, and many of those with AC engaged in limited use due primarily to the high cost of electricity. Adaptation behaviors include staying hydrated, remaining indoors or going to cooler locations, reducing energy usage, and consuming certain foods and drinks. Most of the participants reported some physical or mental health problem or symptom during heat waves, suggesting vulnerability to heat waves. Almost all participants asserted that heat waves were likely to increase in frequency and intensity with adverse health effects for vulnerable populations. Despite limited resources, low-income residents of urban heat islands utilize a wide range of behaviors to minimize the severity of health impacts, suggesting they are both vulnerable and resilient to heat waves.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Michael S. Hurlburt
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Cecilia Fernandez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Jessenia De Leon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Kexin Yu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Erika Salinas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Md. Mostafijur Rahman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Sam J. Silva
- Department of Earth Sciences, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Rob S. McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
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Sletten TL, Sullivan JP, Arendt J, Palinkas LA, Barger LK, Fletcher L, Arnold M, Wallace J, Strauss C, Baker RJS, Kloza K, Kennaway DJ, Rajaratnam SMW, Ayton J, Lockley SW. The role of circadian phase in sleep and performance during Antarctic winter expeditions. J Pineal Res 2022; 73:e12817. [PMID: 35833316 PMCID: PMC9541096 DOI: 10.1111/jpi.12817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Abstract
The Antarctic environment presents an extreme variation in the natural light-dark cycle which can cause variability in the alignment of the circadian pacemaker with the timing of sleep, causing sleep disruption, and impaired mood and performance. This study assessed the incidence of circadian misalignment and the consequences for sleep, cognition, and psychological health in 51 over-wintering Antarctic expeditioners (45.6 ± 11.9 years) who completed daily sleep diaries, and monthly performance tests and psychological health questionnaires for 6 months. Circadian phase was assessed via monthly 48-h urine collections to assess the 6-sulphatoxymelatonin (aMT6s) rhythm. Although the average individual sleep duration was 7.2 ± 0.8 h, there was substantial sleep deficiency with 41.4% of sleep episodes <7 h and 19.1% <6 h. Circadian phase was highly variable and 34/50 expeditioners had sleep episodes that occurred at an abnormal circadian phase (acrophase outside of the sleep episode), accounting for 18.8% (295/1565) of sleep episodes. Expeditioners slept significantly less when misaligned (6.1 ± 1.3 h), compared with when aligned (7.3 ± 1.0 h; p < .0001). Performance and mood were worse when awake closer to the aMT6s peak and with increased time awake (all p < .0005). This research highlights the high incidence of circadian misalignment in Antarctic over-wintering expeditioners. Similar incidence has been observed in long-duration space flight, reinforcing the fidelity of Antarctica as a space analog. Circadian misalignment has considerable safety implications, and potentially longer term health risks for other circadian-controlled physiological systems. This increased risk highlights the need for preventative interventions, such as proactively planned lighting solutions, to ensure circadian alignment during long-duration Antarctic and space missions.
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Affiliation(s)
- Tracey L. Sletten
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityVictoriaAustralia
| | - Jason P. Sullivan
- Division of Sleep and Circadian Disorders, Departments of Medicine and NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Josephine Arendt
- Faculty of Health and Medical SciencesUniversity of SurreyGuildfordSurreyUK
| | - Lawrence A. Palinkas
- Suzanne Dworak‐Peck School of Social WorkUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Laura K. Barger
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityVictoriaAustralia
- Division of Sleep and Circadian Disorders, Departments of Medicine and NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Division of Sleep Medicine, Harvard Medical SchoolBostonMassachusettsUSA
| | - Lloyd Fletcher
- Polar Medicine Unit, Australian Antarctic DivisionKingstonTasmaniaAustralia
| | - Malcolm Arnold
- Polar Medicine Unit, Australian Antarctic DivisionKingstonTasmaniaAustralia
| | - Jan Wallace
- Polar Medicine Unit, Australian Antarctic DivisionKingstonTasmaniaAustralia
| | - Clive Strauss
- Polar Medicine Unit, Australian Antarctic DivisionKingstonTasmaniaAustralia
| | | | - Kate Kloza
- Polar Medicine Unit, Australian Antarctic DivisionKingstonTasmaniaAustralia
| | - David J. Kennaway
- Robinson Research Institute, School of Medicine, Discipline of Obstetrics and GynaecologyUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Shantha M. W. Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityVictoriaAustralia
- Division of Sleep and Circadian Disorders, Departments of Medicine and NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Division of Sleep Medicine, Harvard Medical SchoolBostonMassachusettsUSA
| | - Jeff Ayton
- Polar Medicine Unit, Australian Antarctic DivisionKingstonTasmaniaAustralia
| | - Steven W. Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Division of Sleep Medicine, Harvard Medical SchoolBostonMassachusettsUSA
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Scott K, Guigayoma J, Palinkas LA, Beaudoin FL, Clark MA, Becker SJ. The measurement-based care to opioid treatment programs project (MBC2OTP): a study protocol using rapid assessment procedure informed clinical ethnography. Addict Sci Clin Pract 2022; 17:44. [PMID: 35986380 PMCID: PMC9389829 DOI: 10.1186/s13722-022-00327-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background Psychosocial interventions are needed to enhance patient engagement and retention in medication treatment within opioid treatment programs. Measurement-based care (MBC), an evidence-based intervention structure that involves ongoing monitoring of treatment progress over time to assess the need for treatment modifications, has been recommended as a flexible and low-cost intervention for opioid treatment program use. The MBC2OTP Project is a two-phase pilot hybrid type 1 effectiveness-implementation trial that has three specific aims: (1) to employ Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) to collect mixed methods data to inform MBC implementation; (2) to use RAPICE data to adapt an MBC protocol; and (3) to conduct a hybrid type 1 trial to evaluate MBC’s preliminary effectiveness and implementation potential in opioid treatment programs. Methods This study will be conducted in two phases. Phase 1 will include RAPICE site visits, qualitative interviews (N = 32–48 total), and quantitative surveys (N = 64–80 total) with staff at eight programs to build community partnerships and evaluate contextual factors impacting MBC implementation. Mixed methods data will be analyzed using immersion/crystallization and thematic analysis to inform MBC adaptation and site selection. Four programs selected for Phase 2 will participate in MBC electronic medical record integration, training, and ongoing support. Chart reviews will be completed in the 6 months prior-to and following MBC integration (N = 160 charts, 80 pre and post) to evaluate effectiveness (patient opioid abstinence and treatment engagement) and implementation outcomes (counselor MBC exposure and fidelity). Discussion This study is among the first to take forward recommendations to implement and evaluate MBC in opioid treatment programs. It will also employ an innovative RAPICE approach to enhance the quality and rigor of data collection and inform the development of an MBC protocol best matched to opioid treatment programs. Overall, this work seeks to enhance treatment provision and clinical outcomes for patients with opioid use disorder. Trial registration This study will be registered with Clinicaltrials.gov within 21 days of first participant enrollment in Phase 2. Study Phase 1 (RAPICE) does not qualify as a clinical trial, therefore Phase 2 clinical trial registration has not yet been pursued because all elements of Phase 2 will be dependent on Phase 1 outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s13722-022-00327-0.
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Palinkas LA, O’Donnell M, Kemp S, Tiatia J, Duque Y, Spencer M, Basu R, Del Rosario KI, Diemer K, Doma B, Forbes D, Gibson K, Graff-Zivin J, Harris BM, Hawley N, Johnston J, Lauraya F, Maniquiz NEF, Marlowe J, McCord GC, Nicholls I, Rao S, Saunders AK, Sortino S, Springgate B, Takeuchi D, Ugsang J, Villaverde V, Wells KB, Wong M. Regional Research-Practice-Policy Partnerships in Response to Climate-Related Disparities: Promoting Health Equity in the Pacific. Int J Environ Res Public Health 2022; 19:9758. [PMID: 35955120 PMCID: PMC9368677 DOI: 10.3390/ijerph19159758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Although climate change poses a threat to health and well-being globally, a regional approach to addressing climate-related health equity may be more suitable, appropriate, and appealing to under-resourced communities and countries. In support of this argument, this commentary describes an approach by a network of researchers, practitioners, and policymakers dedicated to promoting climate-related health equity in Small Island Developing States and low- and middle-income countries in the Pacific. We identify three primary sets of needs related to developing a regional capacity to address physical and mental health disparities through research, training, and assistance in policy and practice implementation: (1) limited healthcare facilities and qualified medical and mental health providers; (2) addressing the social impacts related to the cooccurrence of natural hazards, disease outbreaks, and complex emergencies; and (3) building the response capacity and resilience to climate-related extreme weather events and natural hazards.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Meaghan O’Donnell
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Susan Kemp
- School of Counseling, Human Services and Social Work, University of Auckland, Auckland 1010, New Zealand
| | - Jemaima Tiatia
- Te Wānanga o Waipapa, School of Māori Studies and Pacific Studies at the University of Auckland, Auckland 1010, New Zealand
| | - Yvonette Duque
- Asian Disaster Preparedness Center, Bangkok 10400, Thailand
| | - Michael Spencer
- School of Social Work, University of Washington, Seattle, WA 98195, USA
| | - Rupa Basu
- Office of Environmental Health Hazard Assessment (OEHHA), California Environmental Protection Agency, Sacramento, CA 95812, USA
| | | | - Kristin Diemer
- School of Social Work, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Bonifacio Doma
- Department of Chemical Engineering, Mapua University, Manila 1102, Philippines
| | - David Forbes
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Kari Gibson
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Joshua Graff-Zivin
- School of Global Policy and Strategy, University of California, San Diego, CA 92093, USA
| | - Bruce M. Harris
- Provincial Government of New Ireland, Kavieng 631, Papua New Guinea
| | - Nicola Hawley
- Department of Epidemiology and Chronic Disease, School of Public Health, Yale University, New Haven, CT 06520, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Fay Lauraya
- Office of the President, University of Nueva Caceres, Naga 4400, Philippines
| | | | - Jay Marlowe
- School of Counseling, Human Services and Social Work, University of Auckland, Auckland 1010, New Zealand
| | - Gordon C. McCord
- School of Global Policy and Strategy, University of California, San Diego, CA 92093, USA
| | - Imogen Nicholls
- International Organization for Migration, Canberra, ACT 2601, Australia
| | - Smitha Rao
- College of Social Work, Ohio State University, Columbus, OH 43210, USA
| | | | - Salvatore Sortino
- International Organization for Migration, Majuro 96960, Marshall Islands
| | - Benjamin Springgate
- School of Medicine, LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA
- School of Public Health, LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA
| | - David Takeuchi
- School of Social Work, University of Washington, Seattle, WA 98195, USA
| | - Janette Ugsang
- Asian Disaster Preparedness Center, Bangkok 10400, Thailand
| | - Vivien Villaverde
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Kenneth B. Wells
- Center for Health Services and Society, Jane and Terry Semel Institute, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Marleen Wong
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
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Purtle J, Nelson KL, Lengnick‐Hall R, Horwitz SMC, Palinkas LA, McKay MM, Hoagwood KE. Inter-agency collaboration is associated with increased frequency of research use in children's mental health policy making. Health Serv Res 2022; 57:842-852. [PMID: 35285023 PMCID: PMC9264471 DOI: 10.1111/1475-6773.13955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine whether the self-report frequency of inter-agency collaboration about children's mental health issues is associated with the self-report frequency of using research evidence in children's mental health policy and program decision making in mental health agencies (MHAs). DATA SOURCES Primary data were collected through web-based surveys of state (N = 221) and county (N = 117) MHA officials. DESIGN The primary independent variable was a composite score quantifying the frequency of collaboration about children's mental health issues between officials in MHAs and six other state agencies. The dependent variables were composite scores quantifying the frequency of research use in children's mental health policy and program decision making in general and for specific purposes (i.e., conceptual, instrumental, tactical, imposed). Covariates were composite scores quantifying well-established determinants of research use (e.g., agency leadership, research use skills) in agency policy and program decision making. DATA METHODS Separate multiple linear regression models estimated associations between frequency of inter-agency collaboration and research use scores, adjusting for other determinants of research use, respondent state, and other covariates. Data from state and county officials were analyzed separately. PRINCIPAL FINDINGS The frequency of inter-agency collaboration was positively and independently associated with the frequency of research use in children's mental health policy making among state (β = 0.22, p = 0.004) and county (β = 0.39, p < 0.0001) MHA officials. Inter-agency collaboration was also the only variable significantly associated with the frequency of research use for all four specific purposes among state MHA officials, and similar findings we observed among county MHA officials. The magnitudes of associations between inter-agency collaboration and frequency of research use were generally stronger than for more well-established determinants of research use in policy making. CONCLUSIONS Strategies that promote collaboration between MHA officials and external agencies could increase the use of research evidence in children's mental health policy and program decision making in MHAs.
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Affiliation(s)
- Jonathan Purtle
- Department of Public Health Policy & ManagementSchool of Global Public Health, Global Center for Implementation Science, New York UniversityNew YorkNew YorkUSA
| | - Katherine L. Nelson
- Department of Health Management and PolicyDrexel University Dornsife School of Public HealthPhiladelphiaPennsylvaniaUSA
| | | | - Sarah Mc Cue Horwitz
- Department of Child and Adolescent PsychiatryNew York University School of MedicineNew YorkNew YorkUSA
| | - Lawrence A. Palinkas
- Suzanne Dworak‐Peck School of Social WorkUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Mary M. McKay
- Washington University in St. Louis, Brown SchoolSt. LouisMissouriUSA
| | - Kimberly E. Hoagwood
- Department of Child and Adolescent PsychiatryNew York University School of MedicineNew YorkNew YorkUSA
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19
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Rahman MM, Garcia E, Lim CC, Ghazipura M, Alam N, Palinkas LA, McConnell R, Thurston G. Temperature variability associations with cardiovascular and respiratory emergency department visits in Dhaka, Bangladesh. Environ Int 2022; 164:107267. [PMID: 35533532 DOI: 10.1016/j.envint.2022.107267] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/30/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Greenhouse gas emissions are changing the Earth's climate, most directly by modifying temperatures and temperature variability (TV). Residents of low- and middle-income countries (LMICs) are likely more adversely affected, due to lack of air conditioning to compensate. To date, there is no local epidemiological evidence documenting the cardio-respiratory health effects of TV in Dhaka, Bangladesh, one of the most climate change vulnerable cities in the world. OBJECTIVES We assessed short-term TV associations with daily cardiovascular disease (CVD) and respiratory emergency department (ED) visits, as well as effect modification by age and season. METHODS TV was calculated from the standard deviations of the daily minimum and maximum temperatures over exposure days. Time-series regression modeling was applied to daily ED visits for respiratory and CVD from January 2014 through December 2017. TV effect sizes were estimated after controlling for long-term trends and seasonality, day-of-week, holidays, and daily mean relative humidity and ambient temperature. RESULTS A 1 °C increase in TV was associated with a 1.00% (95 %CI: 0.05%, 1.96%) increase in CVD ED visits at lag 0-1 days (TV0-1) and a 2.77% (95 %CI: 0.24%, 5.20%) increase in respiratory ED visits at lag 0-7 days (TV0-7). TV-CVD associations were larger in the monsoon and cold seasons. Respiratory ED visit associations varied by age, with older adults more affected by the TV across all seasons. A 1 °C increase in TV at lag 0-7 days (TV0-7) was associated with a 7.45% (95 %CI: 2.33%, 12.57%) increase in respiratory ED visits among patients above 50 years of age. CONCLUSION This study provided novel and important evidence that cardio-pulmonary health in Dhaka is adversely affected year-round by day-to-day increases in TV, especially among older adults. TV is a key factor that should be considered in evaluating the potential human health impacts of climate change induced temperature changes.
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Affiliation(s)
- Md Mostafijur Rahman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chris C Lim
- Department of Community, Environment, and Policy at the Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Marya Ghazipura
- New York University Langone Health, Department of Population Health, New York, NY; ZS Associates, Global Health Economics and Outcomes Research, New York, NY
| | - Nur Alam
- Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
| | - Lawrence A Palinkas
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - George Thurston
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population Health, New York University School of Medicine, New York, NY, USA
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20
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Palinkas LA. Mixed method designs. Implement Sci 2022. [DOI: 10.4324/9781003109945-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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21
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Purtle J, Nelson KL, Horwitz SM, Palinkas LA, McKay MM, Hoagwood KE. Impacts of COVID-19 on Mental Health Safety Net Services for Youths: A National Survey of Agency Officials. Psychiatr Serv 2022; 73:381-387. [PMID: 34320821 PMCID: PMC8799776 DOI: 10.1176/appi.ps.202100176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mental health agencies provide critical safety net services for youths. No research has assessed impacts of the COVID-19 pandemic on services these agencies provide or youths they serve. This study sought to characterize agency officials' perceptions of the pandemic's impacts on youths and challenges to providing youth services during the pandemic and to examine associations between these challenges and impacts. METHODS Surveys were completed in September-October 2020 by 159 state or county mental health agency officials from 46 states. Respondents used 7-point scales (higher rating indicated more severe impact or challenge) to rate the pandemic's impact on youth mental health issues, general service challenges, and telepsychiatry service challenges across patient, provider, and financing domains. Multiple linear regression models estimated associations between service challenges (independent variables) and pandemic impacts (dependent variables). RESULTS Most agency officials perceived the pandemic as having disproportionately negative mental health impacts on socially disadvantaged youths (serious impact, 72%; mean rating=5.85). Only 15% (mean=4.29) perceived the pandemic as having a seriously negative impact on receipt of needed youth services. Serious service challenges were related to youths' lack of reliable equipment or Internet access for telepsychiatry services (serious challenge, 59%; mean=5.47) and the inability to provide some services remotely (serious challenge, 42%, mean=4.72). In regression models, the inability to provide some services remotely was significantly (p≤0.01) associated with three of five pandemic impacts. CONCLUSIONS Officials perceived the COVID-19 pandemic as exacerbating youth mental health disparities but as not having a dramatic impact on receipt of needed services.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Sarah McCue Horwitz
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Lawrence A Palinkas
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Mary M McKay
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
| | - Kimberly E Hoagwood
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia (Purtle, Nelson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Palinkas); Brown School, Washington University in St. Louis, St. Louis (McKay)
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22
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Um MY, Rice E, Lee JO, Kim HJ, Palinkas LA. Suicidal ideation among North Korean refugees in South Korea: Exploring the influence of social network characteristics by gender. Transcult Psychiatry 2022; 59:52-62. [PMID: 32691690 DOI: 10.1177/1363461520935314] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rates of death by suicide among North Korean refugees are three times higher than those among their host-country counterparts in South Korea. However, social and cultural factors predicting suicidality among North Korean refugees are not well known. Thus, we explored how social networks affect suicidal ideation in a sample of 405 North Korean refugees in South Korea using egocentric network data. Network diversity (number of different types of ties) was a protective factor for suicidal ideation among women. Having a help-providing and trustworthy church-based tie was a protective factor for women, whereas it was a risk factor for men. It is likely that women connected to people in diverse social contexts received more support to effectively deal with adversities. Because South Korean churches provide tailored worship services and financial aid to North Korean refugees, women might receive emotional comfort from church-based ties whom they can trust and receive help from, whereas men might become distressed about being financially dependent on others, which contradicts cultural expectations of a man's traditional role. Our findings have implications for mental health practitioners serving vulnerable populations, and highlight the importance of understanding the cultural context of social networks and gender in suicide research.
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23
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Eisman AB, Palinkas LA, Brown S, Lundahl L, Kilbourne AM. A mixed methods investigation of implementation determinants for a school-based universal prevention intervention. Implement Res Pract 2022; 3:26334895221124962. [PMID: 37091102 PMCID: PMC9978636 DOI: 10.1177/26334895221124962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Effective implementation of evidence-based prevention interventions in schools is vital to reducing the burden of drug use and its consequences. Universal prevention interventions often fail to achieve desired public health outcomes due to poor implementation. One central reason for suboptimal implementation is the limited fit between the intervention and the setting. Research is needed to increase our understanding of how intervention characteristics and context influence intervention implementation in schools to design implementation strategies that will address barriers and improve public health impact. Methods Using a convergent mixed methods design we examined qualitative and quantitative data on implementation determinants for an evidence-based health curriculum, the Michigan Model for HealthTM (MMH) from the perspective of health teachers delivering the curriculum in high schools across the state. We examined data strands independently and integrated them by investigating data alignment, expansion, and divergence. Results We identified three mixed methods domains: (1) Acceptability, (2) intervention-context fit, and (3) adaptability. We found alignment across data strands as teachers reporting low acceptability also reported low fidelity. The fit between student needs and the curriculum predicted fidelity (expansion). Teachers mentioned instances of poor intervention-context fit (discordance), including when meeting the needs of trauma-exposed youth and keeping updated on youth drug use trends. Teachers reported high adaptability (concordance) but also instances when adaptation was challenging (discordance). Conclusions This investigation advances implementation research by deepening our understanding of implementation determinants for an evidence-based universal prevention intervention in schools. This will support designing effective implementation strategies to address barriers and advance the public health impact of interventions that address important risk and protective factors for all youth. Plain Language Summary (1) What is Already Known About the Topic? While many evidence-based interventions (EBIs) exist to address key health issues among youth including substance use and mental health, few of these interventions are effectively implemented in community settings, such as schools. Notable multilevel barriers exist to implement universal prevention in schools. Researchers identify that misalignment between the intervention and the context is a key reason why many implementation efforts do not achieve desired outcomes. (2) What Does This Paper Add? This paper combines the strengths of qualitative and quantitative research methods to identify and understand challenges to intervention-context fit for a comprehensive health curriculum, the Michigan Model for HealthTM (MMH) which is widely adopted throughout Michigan, from the perspective of end users. This paper also utilizes the consolidated framework for implementation research and implementation outcomes framework to guide our understanding of implementing complex interventions and key barriers to implementation in schools. This research provides a foundation to design effective strategies that will balance curriculum fidelity and adaptation to achieve public health objectives. (3) What are the Implications for Practice, Research, or Policy? We need implementation strategies that guide flexibility and fidelity in EBI delivery in schools. While overall teachers felt the curriculum was adaptable and met student needs, they also mentioned specific instances when they would benefit from additional implementation support, such as making adaptations to meet the needs of trauma-exposed youth and keeping up-to-date with emerging drugs. Implementation strategies designed to address these challenges can improve fidelity and ultimately student well-being.
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Affiliation(s)
- Andria B. Eisman
- Community Health, Division of Kinesiology, Health and Sport Studies,
College of Education, Wayne State University, Detroit, MI, USA
- Center for Health and Community Impact, College of Education, Wayne State University, Detroit, MI, USA
| | - Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern
California, Los Angeles, CA, USA
| | - Suzanne Brown
- School of Social Work, Wayne State University, Detroit, MI, USA
| | - Leslie Lundahl
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Amy M. Kilbourne
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
- Health Services Research and Development, Veterans Health
Administration, U.S. Department of Veterans Affairs, Washington, DC, USA
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24
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Eisman AB, Kiperman S, Rupp LA, Kilbourne AM, Palinkas LA. Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative study. Transl Behav Med 2021; 12:411-422. [PMID: 34964893 PMCID: PMC8929750 DOI: 10.1093/tbm/ibab162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This study examined how teachers discuss various factors as impacting their ability to execute with fidelity the Michigan Model for Health (MMH), an evidence-based health universal prevention curriculum widely adopted throughout Michigan. Researchers have found a robust relationship between fidelity and participant outcomes, including in schools. While previous studies have identified barriers that inhibit fidelity, few have focused on identifying key barriers and deepening our understanding of how these factors influence intervention fidelity. We conducted a thematic analysis using the reflexive thematic approach to identify key barriers and facilitators and deepen our understanding of how these factors influence MMH implementation. Guided by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcomes Framework, we conducted semistructured interviews with 23 high school health teachers across Michigan. Teachers identified intervention characteristics (e.g., design quality, packaging, and program adaptability), student needs (e.g., trauma exposure, substances), and the fit between the intervention and the context as factors that contributed to acceptability. They also discussed the curriculum and its alignment with their teaching style and/or experiences as contributing to fidelity. Teachers shared how they would often go "off protocol" to improve intervention-context fit and meet students' needs. Our results identified acceptability, a perceptual implementation outcome, as demonstrating an important role in shaping the relationship between CFIR factors and fidelity. Results provide guidance for systematically designing implementation strategies that address key barriers to improve acceptability, enhance fidelity, and ultimately achieve desired public health objectives.
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Affiliation(s)
- Andria B Eisman
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA,Center for Health and Community Impact, Wayne State University, Detroit, MI 48202, USA,Correspondence to: A B Eisman,
| | - Sarah Kiperman
- Educational Psychology, College of Education, Wayne State University, Detroit, MI 48202, USA
| | - Laney A Rupp
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Amy M Kilbourne
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI 48109, USA,Quality Enhancement Research Initiative, U.S. Department of Veterans Affairs, Washington, DC 20420, USA
| | - Lawrence A Palinkas
- School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
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25
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Javier JR, Deavenport-Saman A, Florendo E, Bantol KEA, Palinkas LA. Health Equity and Enrollment in Preventive Parenting Programs: A Qualitative Study of Filipino Parents. Evid Based Pract Child Adolesc Ment Health 2021; 7:245-259. [PMID: 35783995 PMCID: PMC9246343 DOI: 10.1080/23794925.2021.2013141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This qualitative study identified the parent health beliefs and normative beliefs related to child behavioral and mental health problems and examined the benefits and barriers of enrolling in an evidence-based parenting intervention among Filipino parents of school-aged children. A secondary aim was to also use the results to inform the development of a theory-based video intervention to increase enrollment in parenting interventions. Semi-structured interviews were conducted with fifteen parents who had or had not participated in the Incredible Years® parenting program, an evidence-based parenting intervention. Interviews were recorded and transcribed verbatim. Using a "Coding Consensus, Co-occurrence, and Comparison" methodology, emergent themes were mapped into a matrix against a priori-coded health belief model (HBM) and Theory of Planned Behavior (TPB) constructs. Parents believed that perceived susceptibility could be influenced by including knowledge of health disparities affecting Filipino youth in the U.S. Perceived severity was related to behavioral and mental health concerns about school, family dynamics, bullying and parent coping strategies. Perceived benefits included strengthening parent-child relationships, creating support systems, and learning positive parenting skills. Perceived barriers included logistics, stigma, and the perception of the relevance of the program, cultural factors such as generational differences about parenting, and family issues. Social norms and subjective norms related to parent participation were also discussed. Applying the HBM and TPB to enrollment in parenting interventions may explain low enrollment rates. Future interventions need to target perceived susceptibility to future behavioral health problems, barriers, and benefits to enrollment, and influence subjective and social norms.
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Affiliation(s)
- Joyce R. Javier
- Children’s Hospital Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Alexis Deavenport-Saman
- Children’s Hospital Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Ellynore Florendo
- Children’s Hospital Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Kamil Evy A. Bantol
- Children’s Hospital Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Lawrence A. Palinkas
- University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, California, USA
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26
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Harris SM, Sandal GM, Bye HH, Palinkas LA, Binder PE. Integration Is Correlated With Mental Health Help-Seeking From the General Practitioner: Syrian Refugees' Preferences and Perceived Barriers. Front Public Health 2021; 9:777582. [PMID: 34917581 PMCID: PMC8669439 DOI: 10.3389/fpubh.2021.777582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Despite a seemingly higher need, refugees in Europe tend to underuse mental health (MH) services. To better understand this underuse, it is important to understand refugees' willingness and ability to seek help from their general practitioner (GP) when experiencing MH problems. We employed a combined vignette and survey design to explore how the GP fits into the larger context of help-seeking preferences among a sample of Syrian refugees in Norway (n = 92), and what barriers they perceive in accessing help from the GP. We also examined how indicators of integration relate to seeking help from the GP. We take an exploratory approach. Participants were presented a vignette of an individual with symptoms in line with ICD-10 and DSM-5 criteria for depression. Participants were somewhat likely to seek help from the GP; however, seeking help from one's relationship with Allah/God and one's partner was preferred. Furthermore, while the GP was rated a somewhat likely help-seeking source, most participants indicated an average of two barriers to seeking help from the GP. Finally, social ties to the majority population in the form of social integration and feelings of connectedness with the host country (psychological integration) were positively correlated with likelihood of seeking help from the GP. Taken together, these findings suggest that the GP is considered a viable source of help among Syrians with a refugee background in the current sample, but that this may be influenced by perceived barriers and social as well as psychological integration. Addressing these barriers and promoting psychosocial integration with the host country are key to facilitating access and usage amongst refugees in need of MH services.
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Affiliation(s)
- Samantha Marie Harris
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Gro M Sandal
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Hege H Bye
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Per-Einar Binder
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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27
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Springgate BF, Sugarman O, Wells KB, Palinkas LA, Meyers D, Wennerstrom A, Johnson A, Haywood C, Sarpong D, Culbertson R. Community Partnered Participatory Research in Southeast Louisiana Communities Threatened by Climate Change: The C-LEARN EXPERIENCE. Am J Bioeth 2021; 21:46-48. [PMID: 34554077 DOI: 10.1080/15265161.2021.1965248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
| | | | - Kenneth B Wells
- University of California, Los Angeles Semel Neuropsychiatric Institute
| | | | - Diana Meyers
- St. Anna Episcopal Church and Anna's Place NOLA, New Orleans, Louisiana
| | | | - Arthur Johnson
- Lower Ninth Ward Center for Sustainable Engagement and Development, New Orleans, Louisiana
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28
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Palinkas LA, De Leon J, Salinas E, Chu S, Hunter K, Marshall TM, Tadehara E, Strnad CM, Purtle J, Horwitz SM, McKay MM, Hoagwood KE. Impact of the COVID-19 Pandemic on Child and Adolescent Mental Health Policy and Practice Implementation. Int J Environ Res Public Health 2021; 18:ijerph18189622. [PMID: 34574547 PMCID: PMC8467758 DOI: 10.3390/ijerph18189622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
Background: The impact of the 2019 coronavirus pandemic on the mental health of millions worldwide has been well documented, but its impact on prevention and treatment of mental and behavioral health conditions is less clear. The COVID-19 pandemic also created numerous challenges and opportunities to implement health care policies and programs under conditions that are fundamentally different from what has been considered to be usual care. Methods: We conducted a qualitative study to determine the impact of the COVID-19 pandemic on implementation of evidence-based policy and practice by State Mental Health Authorities (SMHA) for prevention and treatment of mental health problems in children and adolescents. Semi-structured interviews were conducted with 29 SMHA representatives of 21 randomly selected states stratified by coronavirus positivity rate and rate of unmet services need. Data analysis with SMHA stakeholders used procedures embedded in the Rapid Assessment Procedure—Informed Community Ethnography methodology. Results: The need for services increased during the pandemic due primarily to family stress and separation from peers. States reporting an increase in demand had high coronavirus positivity and high unmet services need. The greatest impacts were reduced out-of-home services and increased use of telehealth. Barriers to telehealth services included limited access to internet and technology, family preference for face-to-face services, lack of privacy, difficulty using with young children and youth in need of substance use treatment, finding a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform, training providers and clients, and reimbursement challenges. Policy changes to enable reimbursement, internet access, training, and provider licensing resulted in substantially fewer appointment cancellations or no-shows, greater family engagement, reduction in travel time, increased access for people living in remote locations, and increased provider communication and collaboration. States with high rates of coronavirus positivity and high rates of unmet need were most likely to continue use of telehealth post-pandemic. Despite these challenges, states reported successful implementation of policies designed to facilitate virtual services delivery with likely long-term changes in practice. Conclusions: Policy implementation during the pandemic provided important lessons for planning and preparedness for future public health emergencies. Successful policy implementation requires ongoing collaboration among policy makers and with providers.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
- Correspondence: ; Tel.: +1-858-922-7265; Fax: +1-213-740-0789
| | - Jessenia De Leon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
| | - Erika Salinas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
| | - Sonali Chu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA; (J.D.L.); (E.S.); (S.C.)
| | - Katharine Hunter
- Office of Child and Family Services, Virginia Department of Behavioral Health and Developmental Services, Richmond, VA 23218, USA;
| | - Timothy M. Marshall
- Office of Community Mental Health, Connecticut Department of Children and Families, Hartford, CT 06103, USA;
| | - Eric Tadehara
- Utah Department of Human Services, Substance Abuse and Mental Health, Salt Lake City, UT 84116, USA;
| | - Christopher M. Strnad
- Office of Children’s Behavioral Health, Department of Children, Youth and Families, Providence, RI 02903, USA;
| | - Jonathan Purtle
- Department of Health Management & Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA;
| | - Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA; (S.M.H.); (K.E.H.)
| | - Mary M. McKay
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Kimberly E. Hoagwood
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA; (S.M.H.); (K.E.H.)
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Palinkas LA, Engstrom A, Whiteside L, Moloney K, Zatzick D. A Rapid Ethnographic Assessment of the Impact of the COVID-19 Pandemic on Mental Health Services Delivery in an Acute Care Medical Emergency Department and Trauma Center. Adm Policy Ment Health 2021; 49:157-167. [PMID: 34319464 PMCID: PMC8317683 DOI: 10.1007/s10488-021-01154-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 01/25/2023]
Abstract
A rapid ethnographic assessment of delivery of mental health services to patients at a Level I trauma center in a major metropolitan hospital undergoing a COVID-19 surge was conducted to assess the challenges involved in services delivery and to compare the experience of delivering services across time. Study participants were patients and providers who interacted with or otherwise were observed by three clinicians engaged in the delivery of care within the Emergency Department (ED) and Trauma Center at Harborview Medical Center from the COVID-19-related "surge" in April to the end of July 2020. Data were collected and analyzed in accordance with the Rapid Assessment Procedures-Informed Clinical Ethnography (RAPICE) protocol. Community and institutional efforts to control the spread of the coronavirus created several challenges to providing mental health services in an acute care setting during the April surge. Most of these challenges were successfully addressed by standardization of infection control protocols, but new challenges emerged including an increase in expenses for infection control and reduction in clinical revenues due to fewer patients, furloughs of mental health services providers and peer specialists in the ED, services not provided or delayed, increased stress due to fear of furloughs or increased workload of those not furloughed, and increases in patients seen with injuries due to risky behavior, violence, and substance use. These findings illustrate the rapidly shifting nature of the pandemic, its impacts on mental health services, and the mitigation efforts of communities and healthcare systems.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90089-0411, USA.
| | - Allison Engstrom
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Lauren Whiteside
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle, WA, USA
| | - Kathleen Moloney
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Douglas Zatzick
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.,Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle, WA, USA
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Zatzick D, Jurkovich G, Heagerty P, Russo J, Darnell D, Parker L, Roberts MK, Moodliar R, Engstrom A, Wang J, Bulger E, Whiteside L, Nehra D, Palinkas LA, Moloney K, Maier R. Stepped Collaborative Care Targeting Posttraumatic Stress Disorder Symptoms and Comorbidity for US Trauma Care Systems: A Randomized Clinical Trial. JAMA Surg 2021; 156:430-474. [PMID: 33688908 DOI: 10.1001/jamasurg.2021.0131] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance To date, few multisite investigations have evaluated early interventions for injured patients with posttraumatic stress disorder (PTSD) symptoms. Objective To simultaneously assess the effectiveness and implementation of a brief stepped collaborative care intervention targeting PTSD and comorbidity. Design, Setting, and Participants A stepped-wedge cluster randomized clinical trial was conducted at 25 US level I trauma centers. Participants included hospitalized survivors of physical injury who underwent a 2-step evaluation for PTSD symptoms. Patients reporting high levels of distress on the PTSD Checklist (PCL-C) were randomized (N = 635) per the stepped-wedge protocol to enhanced usual care control (n = 370) or intervention (n = 265) conditions. The study was conducted from January 4, 2016, through November 2018. Data analysis was performed from November 4, 2019, to December 8, 2020. Interventions The Trauma Survivors Outcomes and Support collaborative care intervention included proactive injury case management that assisted patients transitioning from hospital inpatient to outpatient and community settings. The intervention also integrated evidence-based pharmacotherapy and psychotherapeutic elements targeting PTSD symptoms and comorbidity. Main Outcomes and Measures The primary study outcome was PTSD symptoms assessed with the PCL-C at baseline in the surgical ward and at 3, 6, and 12 months postinjury. Secondary outcomes included depressive symptoms, alcohol use, and physical function. Subgroup analyses examined the effect of baseline risk factors for enduring PTSD and quality of protocol implementation on study outcomes. Primary statistical analyses were conducted using the intent-to-treat sample. Results A total of 327 men (51.5%) were included in analysis; mean (SD) age was 39.0 (14.2) years. The investigation attained follow-up of 75% to 80% of the participants at 3 to 12 months. The intervention lasted a mean (SD) of 122 (132) minutes. Mixed model regression analyses revealed statistically significant changes in PCL-C scores for intervention patients compared with control patients at 6 months (difference, -2.57; 95% CI, -5.12 to -0.03; effect size, 0.18; P < .05) but not 12 months (difference, -1.27; 95% CI, -4.26 to 1.73; effect size, 0.08; P = .35). Subgroup analyses revealed larger PTSD treatment effects for patients with 3 or more baseline risk factors for enduring PTSD and for patients, including firearm injury survivors, treated at trauma centers with good or excellent protocol implementation. Intervention effects for secondary outcomes did not attain statistical significance. Conclusions and Relevance A brief stepped collaborative care intervention was associated with significant 6-month but not 12-month PTSD symptom reductions. Greater baseline PTSD risk and good or excellent trauma center protocol implementation were associated with larger PTSD treatment effects. Orchestrated efforts targeting policy and funding should systematically incorporate the study findings into national trauma center requirements and verification criteria. Trial Registration ClinicalTrials.gov Identifier: NCT02655354.
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Affiliation(s)
- Douglas Zatzick
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.,Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle
| | - Gregory Jurkovich
- Department of Surgery, UC Davis School of Medicine, Sacramento, California
| | - Patrick Heagerty
- Department of Biostatistics, University of Washington School of Public Health, Seattle
| | - Joan Russo
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Doyanne Darnell
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Lea Parker
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.,Department of Psychology, Drexel University College of Arts and Sciences, Philadelphia, Pennsylvania
| | - Michelle K Roberts
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.,Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle
| | - Rddhi Moodliar
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.,Department of Psychology, University of California, Los Angeles
| | - Allison Engstrom
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Jin Wang
- Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle
| | - Eileen Bulger
- Department of Surgery, University of Washington School of Medicine, Seattle
| | - Lauren Whiteside
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle
| | - Deepika Nehra
- Department of Surgery, University of Washington School of Medicine, Seattle
| | - Lawrence A Palinkas
- Department of Children, Youth and Families, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, California
| | - Kathleen Moloney
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Ronald Maier
- Department of Surgery, University of Washington School of Medicine, Seattle
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Palinkas LA, Suedfeld P. Psychosocial issues in isolated and confined extreme environments. Neurosci Biobehav Rev 2021; 126:413-429. [PMID: 33836214 DOI: 10.1016/j.neubiorev.2021.03.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 12/31/2022]
Abstract
PALINKAS, L.A., and P. SUEDFELD. Psychosocial Issues in Isolated and Confined Extreme Environments. NEUROSCI BIOBEHAV REV (1) XXX-XXX, 2020. Psychosocial elements of behavior and performance will significantly impact the outcomes of long duration missions in space, ranging from individual and team decrements to positive benefits associated with successful adaptation. This paper reviews our current understanding of the individual, interpersonal and organizational issues related to living and working in isolated and confined extreme (ICE) environments. Individual issues include changes in emotions and cognitive performance; seasonal syndromes linked to changes in the physical environment; and positive effects of adapting to ICE environments. Interpersonal issues include processes of crew cohesion, tension and conflict; interpersonal relations and social support; the impact of group diversity and leadership styles on small group dynamics; and crew-mission control interactions. Organizational issues include the influence of organizational culture and mission duration on individual and group performance, crew autonomy, and managerial requirements for long duration missions. Improved screening and selection, leadership, coping and interpersonal skills training, and organizational change are key elements to optimizing adjustment to the environment and preventing decrements during and after long duration missions.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak Peck School of Social Work, University of Southern California, 669 W. 34(th) Street, Los Angeles, CA, 90089-0411, USA.
| | - Peter Suedfeld
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
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Affiliation(s)
- Lawrence A. Palinkas
- Department of Family and Preventive Medicine, University of California, San Diego
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Gertner AK, Franklin J, Roth I, Cruden GH, Haley AD, Finley EP, Hamilton AB, Palinkas LA, Powell BJ. A scoping review of the use of ethnographic approaches in implementation research and recommendations for reporting. Implement Res Pract 2021; 2. [PMID: 34056611 PMCID: PMC8153409 DOI: 10.1177/2633489521992743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Researchers have argued for the value of ethnographic approaches to implementation science (IS). The contested meanings of ethnography pose challenges and possibilities to its use in IS. The goal of this study was to identify sources of commonality and variation, and to distill a set of recommendations for reporting ethnographic approaches in IS. Methods: We included in our scoping review English-language academic journal articles meeting two criteria: (1) IS articles in the healthcare field and (2) articles that described their approach as ethnographic. In March 2019, we implemented our search criteria in four academic databases and one academic journal. Abstracts were screened for inclusion by at least two authors. We iteratively develop a codebook for full-text analysis and double-coded included articles. We summarized the findings and developed reporting recommendations through discussion. Results: Of the 210 articles whose abstracts were screened, 73 were included in full-text analysis. The number of articles increased in recent years. Ethnographic approaches were used within a wide variety of theoretical approaches and research designs. Articles primarily described using interviews and observational methods as part of their ethnographic approaches, though numerous other methods were also employed. The most cited rationales for using ethnographic approaches were to capture context-specific phenomena, understand insiders’ perspective, and study complex interactions. In reporting on ethnographic approaches, we recommend that researchers provide information on researcher training and position, reflect on researchers’ positionality, describe observational methods in detail, and report results from all the methods used. Conclusion: The number of IS studies using ethnography has increased in recent years. Ethnography holds great potential for contributing further to IS, particularly to studying implementation strategy mechanisms and understanding complex adaptive systems. Researchers have proposed that ethnographic methods may be valuable to implementation research and practice. Ethnographic approaches have their roots in the field of anthropology, but they are now used in many fields. These approaches often involve a researcher spending time in “real-world” settings, conducting interviews and observation to understand a group of people. That said, researchers disagree on the meaning of ethnography, which presents a challenge to its use in implementation science (IS). We searched for articles in the field of IS that described their methods as ethnographic. We then reviewed the articles, looking for similarities and differences in how and why ethnographic approaches were used. Many of these articles said they used ethnographic methods because they were interested in issues like context, research participants’ views, and complex interactions. We found a large amount of variation in how ethnographic methods were used. We developed recommendations for describing ethnographic methods in a way that readers can clearly understand. We also made several observations of the value ethnographic approaches can bring to IS. Ethnographic methods may be especially useful to studying unplanned and unexpected changes that take place during implementation. These recommendations and observations could be helpful to implementation researchers wishing to use ethnographic methods.
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Affiliation(s)
- Alex K Gertner
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joshua Franklin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Isabel Roth
- Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | | | - Amber D Haley
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin P Finley
- VA Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Alison B Hamilton
- VA Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Lawrence A Palinkas
- Department of Children, Youth and Families, University of Southern California, Los Angeles, CA, USA
| | - Byron J Powell
- Brown School and School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Um MY, Lee JO, Kim HJ, Rice E, Palinkas LA. Testing the pathway from pre-migration sexual violence to suicide-related risk among North Korean refugee women living in South Korea: do social networks matter? Soc Psychiatry Psychiatr Epidemiol 2021; 56:485-495. [PMID: 33211123 DOI: 10.1007/s00127-020-01977-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 10/24/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine the pathways from pre-migration sexual violence to suicide-related risk via the lack of important social networks among North Korean refugee women living in South Korea. METHODS As part of a larger study, cross-sectional social network data from 273 North Korean refugee women aged 19 or older (M = 41 years; range = 19-69) were collected by self-reported surveys from April to May 2014 in South Korea. Snowball sampling was used for participant recruitment. We analyzed whether lack of network diversity and lack of kin ties mediated the association between pre-migration sexual violence and suicide-related risk in two multivariable mediation analyses. RESULTS The prevalence of past-year suicide-related risk was 34.4% in our study sample, and 31.1% of the participants reported at least one type of pre-migration sexual violence. Pre-migration sexual violence was associated with increased suicide-related risk. Lack of network diversity (b = 0.03, 95% CI 0.01-0.07) and lack of kin ties (b = 0.03, 95% CI 0.01-0.08) partially mediated this association. CONCLUSION Assessment of pre-migration sexual violence victimization needs to begin at an early stage of resettlement. Study findings highlight the urgent need to create suicide prevention programs that incorporate social network interventions, especially for North Korean refugee women who have experienced sexual violence during migration.
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Affiliation(s)
- Mee Young Um
- Arizona State University, Watts College of Public Service and Community Solutions, School of Social Work, Phoenix, AZ, USA
| | - Jungeun Olivia Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Hee Jin Kim
- Myongji University, Bangmok College of General Education, 116 Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi-do, 449-728, South Korea.
| | - Eric Rice
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Lawrence A Palinkas
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
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Morlett Paredes A, Lee EE, Chik L, Gupta S, Palmer BW, Palinkas LA, Kim HC, Jeste DV. Qualitative study of loneliness in a senior housing community: the importance of wisdom and other coping strategies. Aging Ment Health 2021; 25:559-566. [PMID: 31918561 PMCID: PMC7347442 DOI: 10.1080/13607863.2019.1699022] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Older adults are at a high risk for loneliness, which impacts their health, well-being, and longevity. While related to social isolation, loneliness is a distinct, internally experienced, distressing feeling. The present qualitative study sought to identify characteristics of loneliness in older adults living independently within a senior housing community, which is typically designed to reduce social isolation. METHOD Semi-structured qualitative interviews regarding the experience of loneliness, risk factors, and ways to combat it were conducted with 30 older adults, ages 65-92 years. The interviews were audiotaped, transcribed, and coded using a grounded theory analytic approach based on coding, consensus, co-occurrence, and comparison. RESULTS Three main themes with multiple subthemes are described: (A) Risk and Protective factors for loneliness: age-associated losses, lack of social skills or abilities, and protective personality traits; (B) Experience of loneliness: Sadness and lack of meaning as well as Lack of motivation; and (C) Coping strategies to prevent or overcome loneliness: acceptance of aging, compassion, seeking companionship, and environment enables socialization. DISCUSSION Despite living within a communal setting designed to reduce social isolation, many older adults described feeling lonely in stark negative terms, attributing it to aging-associated losses or lack of social skills and abilities. However, interviewees also reported positive personal qualities and actions to prevent or cope with loneliness, several of which mirrored specific components of wisdom. The results support the reported inverse relationship between loneliness and wisdom and suggest a potential role for wisdom-enhancing interventions to reduce and prevent loneliness in older populations.
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Affiliation(s)
- Alejandra Morlett Paredes
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Lisa Chik
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Saumya Gupta
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Barton W. Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Lawrence A. Palinkas
- Department of Family Medicine and Public Health, University of California San Diego
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research-Almaden, San Jose, CA, US
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Neurosciences, University of California San Diego, La Jolla, CA
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Cusworth Walker S, Vick K, Gubner NR, Herting JR, Palinkas LA. Accelerating the conceptual use of behavioral health research in juvenile court decision-making: study protocol. Implement Sci Commun 2021; 2:14. [PMID: 33546742 PMCID: PMC7866460 DOI: 10.1186/s43058-021-00112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The youth criminal-legal system is under heavy political scrutiny with multiple calls for significant transformation. Leaders within the system are faced with rethinking traditional models and are likely to benefit from behavioral health research evidence as they redesign systems. Little is known about how juvenile court systems access and use behavioral health research evidence; further, the field lacks a validated survey measure of behavioral health research use that can be used to evaluate the effectiveness of evidence dissemination interventions for policy and system leaders. Conceptual research use is a particularly salient construct for system reform as it describes the process of shifting awareness and the consideration of new frameworks for action. A tool designed to measure the conceptual use of behavioral health research would advance the field's ability to develop effective models of research evidence dissemination, including collaborative planning models to support the use of behavioral health research in reforms of the criminal-legal system. METHODS The ARC Study is a longitudinal, cohort and measurement validation study. It will proceed in two phases. The first phase will focus on measure development using established methods of construct validity (theoretical review, Delphi methods for expert review, cognitive interviewing). The second phase will involve gathering responses from the developed survey to examine scale psychometrics using Rasch analyses, change sensitivity analyses, and associations between research use exposure and conceptual research use among juvenile court leaders. We will recruit juvenile court leaders (judges, administrators, managers, supervisors) from 80 juvenile court jurisdictions with an anticipated sample size of n = 520 respondents. DISCUSSION The study will introduce a new measurement tool for the field that will advance implementation science methods for the study of behavioral health research evidence use in complex policy and decision-making interventions. To date, there are few validated survey measures of conceptual research use and no measures that are validated for measuring change in conceptual frameworks over time among agency leaders. While the study is most directly related to leaders in the youth criminal-legal system, the findings are expected to be informative for research focused on leadership and decision-making in diverse fields.
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Affiliation(s)
- Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Kristin Vick
- Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Noah R Gubner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Jerald R Herting
- Department of Sociology, University of Washington, Box 353340, 211 Savery Hall, Seattle, WA, 98195, USA
| | - Lawrence A Palinkas
- Department of Children, Youth and Families, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90089-0411, USA
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Stockman JK, Syvertsen JL, Hayashi HD, Ludwig-Barron N, Tsuyuki K, Morris MD, Palinkas LA. "Violence and love and drugs…it all goes hand in hand": A mixed methods analysis of the substance abuse, violence, and HIV/AIDS syndemic among women who use methamphetamine. Subst Abus 2021; 42:821-831. [PMID: 33492198 PMCID: PMC8442613 DOI: 10.1080/08897077.2020.1865242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The synergistic epidemics of substance use, violence, and HIV/AIDS, also known as the SAVA syndemic, disproportionately affects vulnerable women in the United States. Methamphetamine use is closely linked with physical and sexual violence, including intimate partner violence (IPV), which heightens women's vulnerability to HIV. This mixed methods study examined the prevalence and correlates of violence among women who use methamphetamine, (n = 209) enrolled in an HIV intervention study in San Diego, California. Methods: At baseline, 209 women completed an interviewer-administered computer-assisted survey. A sub set of women who reported lifetime IPV (n = 18) also participated in qualitative interviews to contextualize our understanding of patterns of violence over time. Results: In the overall cohort, reports of lifetime (66.0%) and past 2-month (19.6%) IPV were prevalent. Moreover, women reported lifetime physical only (27.3%), sexual only (6.2%), or both forms of violence (50.7%) by multiple perpetrators. Factors independently associated with lifetime IPV were having unprotected sex with a steady partner (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.04, 6.00) and being high on methamphetamine during unprotected sex with a steady partner (OR: 2.56, 95% CI: 1.30, 5.09) within the past 2 months. Our qualitative narratives illuminated how IPV in women's steady relationships often reflects a culmination of violent victimization throughout their lifetime which is further exacerbated by methamphetamine use and sexual risk through gendered power dynamics. Conclusions: HIV prevention interventions should address the SAVA syndemic in a holistic manner, including the role of methamphetamine use in the context of women's abusive steady relationships.
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Affiliation(s)
- Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | - Hitomi D. Hayashi
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, USA
| | - Natasha Ludwig-Barron
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Meghan D. Morris
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Palinkas LA, Springgate BF, Sugarman OK, Hancock J, Wennerstrom A, Haywood C, Meyers D, Johnson A, Polk M, Pesson CL, Seay JE, Stallard CN, Wells KB. A Rapid Assessment of Disaster Preparedness Needs and Resources during the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:ijerph18020425. [PMID: 33430355 PMCID: PMC7825778 DOI: 10.3390/ijerph18020425] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/05/2021] [Accepted: 01/05/2021] [Indexed: 12/25/2022]
Abstract
Background: This year has seen the emergence of two major crises, a significant increase in the frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic. Methods: Semi-structured interviews were conducted with 26 representatives of 24 different community-based programs in southern Louisiana. Data were analyzed using procedures embedded in the Rapid Assessment Procedure-Informed Community Ethnography methodology, using techniques of immersion and crystallization and focused thematic analysis. Results: The pandemic has impacted the form and function of disaster preparedness, making it harder to plan for evacuations in the event of a hurricane. Specific concerns included being able to see people in person, providing food and other resources to residents who shelter in place, finding volunteers to assist in food distribution and other forms of disaster response, competing for funds to support disaster-related activities, developing new support infrastructures, and focusing on equity in disaster preparedness. However, several strengths based on disaster preparedness experience and capabilities were identified, including providing a framework for how to respond and adapt to COVID and integration of COVID response with their normal disaster preparedness activities. Conclusions: Although prior experience has enabled community-based organizations to respond to the pandemic, the pandemic is also creating new challenges to preparing for and responding to natural disasters.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA
- Correspondence: ; Tel.: +1-858-922-7265; Fax: +1-213-740-0789
| | - Benjamin F. Springgate
- LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA; (B.F.S.); (O.K.S.); (A.W.); (C.L.P.); (J.E.S.); (C.N.S.)
| | - Olivia K. Sugarman
- LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA; (B.F.S.); (O.K.S.); (A.W.); (C.L.P.); (J.E.S.); (C.N.S.)
| | - Jill Hancock
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | - Ashley Wennerstrom
- LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA; (B.F.S.); (O.K.S.); (A.W.); (C.L.P.); (J.E.S.); (C.N.S.)
| | - Catherine Haywood
- Louisiana Community Health Outreach Network, New Orleans, LA 70119, USA;
| | - Diana Meyers
- St. Anna’s Episcopal Church, New Orleans, LA 70116, USA;
| | - Arthur Johnson
- Lower Ninth Ward Center for Sustainable Engagement and Development, New Orleans, LA 70117, USA;
| | - Mara Polk
- National Alliance on Metal Illness-New Orleans, New Orleans, LA 70115, USA;
| | - Carter L. Pesson
- LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA; (B.F.S.); (O.K.S.); (A.W.); (C.L.P.); (J.E.S.); (C.N.S.)
| | - Jessica E. Seay
- LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA; (B.F.S.); (O.K.S.); (A.W.); (C.L.P.); (J.E.S.); (C.N.S.)
| | - Caroline N. Stallard
- LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA; (B.F.S.); (O.K.S.); (A.W.); (C.L.P.); (J.E.S.); (C.N.S.)
| | - Kenneth B. Wells
- Center for Health Services and Society, Jane and Terry Semel Institute, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Department of Health Policy and Management, Fielding School of Public Health at UCLA, Los Angeles, CA 90095, USA;
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Um MY, Rice E, Palinkas LA, Kim HJ. Migration-Related Stressors and Suicidal Ideation in North Korean Refugee Women: The Moderating Effects of Network Composition. J Trauma Stress 2020; 33:939-949. [PMID: 32529676 DOI: 10.1002/jts.22549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/10/2019] [Accepted: 01/22/2020] [Indexed: 11/10/2022]
Abstract
Alarmingly high rates of suicidal ideation have been reported in North Korean (NK) refugee women living in South Korea. This population often endures traumatic experiences and violence in North Korea as well as human trafficking and sexual exploitation in intermediary countries. Following resettlement in South Korea, NK refugee women continue facing multiple hardships, such as discrimination, that can negatively affect their mental health and contribute to suicidality. Support from social networks can buffer the harmful impacts of pre- and postmigration stressors on mental health in NK refugee women. Using the stress-buffering hypothesis, the present study examined the moderating effects of network composition (i.e., network diversity and church-based ties) on the associations among premigration trauma, postmigration discrimination, and suicidal ideation in NK refugee women living in South Korea. Participants (N = 273) were NK refugee women living in South Korea who were 19 years of age or older; 34.4% of the participants reported past-year suicidal ideation. The study results indicated that network diversity significantly moderated the association between postmigration discrimination and suicidal ideation, p = .031, whereas networks with church-based ties significantly moderated the association between premigration trauma and suicidal ideation, p = .026. The present findings support the hypothesis that social ties can buffer the appraisal of migration-related stressors on suicidality. These findings have implications for practitioners serving vulnerable populations that experience multiple traumatic events.
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Affiliation(s)
- Mee Young Um
- School of Social Work Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Hee Jin Kim
- Bangmok College of General Education, Myongji University, Seoul, South Korea
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Palinkas LA, O’Donnell ML, Lau W, Wong M. Strategies for Delivering Mental Health Services in Response to Global Climate Change: A Narrative Review. Int J Environ Res Public Health 2020; 17:E8562. [PMID: 33218141 PMCID: PMC7698950 DOI: 10.3390/ijerph17228562] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 01/01/2023]
Abstract
This narrative review examined strategies for preparedness and response to mental health impacts of three forms of climate change from a services perspective: (1) acute and extreme weather events such as hurricanes, floods, and wildfires, (2) sub-acute or long-term events such as droughts and heatwaves; and (3) the prospect of long-term and permanent changes, including higher temperatures, rising sea levels, and an uninhabitable physical environment. Strategies for acute events included development and implementation of programs and practices for monitoring and treating mental health problems and strengthening individual and community resilience, training of community health workers to deliver services, and conducting inventories of available resources and assessments of at-risk populations. Additional strategies for sub-acute changes included advocacy for mitigation policies and programs and adaptation of guidelines and interventions to address the secondary impacts of sub-acute events, such as threats to livelihood, health and well-being, population displacement, environmental degradation, and civil conflict. Strategies for long-lasting changes included the implementation of evidence-based risk communication interventions that address the existing and potential threat of climate change, promoting the mental health benefits of environmental conservation, and promoting psychological growth and resilience.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA;
| | - Meaghan L. O’Donnell
- Phoenix Australia Centre for Posttraumatic Mental Health and Department of Psychiatry, The University of Melbourne, Carlton, VIC 3053, Australia; (M.L.O.); (W.L.)
| | - Winnie Lau
- Phoenix Australia Centre for Posttraumatic Mental Health and Department of Psychiatry, The University of Melbourne, Carlton, VIC 3053, Australia; (M.L.O.); (W.L.)
| | - Marleen Wong
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA;
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Palinkas LA, Whiteside L, Nehra D, Engstrom A, Taylor M, Moloney K, Zatzick DF. Rapid ethnographic assessment of the COVID-19 pandemic April 2020 'surge' and its impact on service delivery in an Acute Care Medical Emergency Department and Trauma Center. BMJ Open 2020; 10:e041772. [PMID: 33082198 PMCID: PMC7577068 DOI: 10.1136/bmjopen-2020-041772] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/23/2020] [Accepted: 10/05/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Assess the impacts of the COVID-19 pandemic on service delivery by frontline healthcare providers in acute care medical and emergency department settings and identify strategies used to cope with pandemic-related physical and mental health demands. DESIGN Rapid clinical ethnography of patient-provider encounters during an initial pandemic 'surge' conducted by a team of clinician-researchers using a structured protocol for qualitative data collection and analysis. SETTING Level 1 trauma centre at Harborview Hospital in Seattle Washington in April 2020. PARTICIPANTS Frontline clinical providers serving as participant observers during performance of their clinical duties recorded observations and summaries of conversations with other providers and patients. RESULTS We identified four different kinds of impacts: procedural, provider, patient and overall. Each impact highlighted two or more levels of a socioecological model of services delivery: (1) the epidemiology of COVID-19, (2) outer setting, (3) inner or organisational setting and (4) individual patient and provider. Despite significant changes in procedures that included COVID-19 screening of all admitted patients, social distancing and use of personal protective equipment, as well as changes in patient and provider behaviour, the overall impact of the pandemic on the emergency department and acute care service delivery was minimal. This is attributed to having a smaller surge than expected, a quick response by the healthcare system to anticipated demands for service delivery and protection of patients and providers, adequate supplies and high provider morale. CONCLUSIONS Although limited to one setting in one healthcare system in one community, the findings offer some important lessons for healthcare systems that have yet to be impacted as well as systems that have been more severely impacted. Each of the socioecological framework levels was found to impact service delivery to patients, and variations at each of these levels account for variations in that quality of care globally.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Lauren Whiteside
- Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Deepika Nehra
- Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Allison Engstrom
- Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Mark Taylor
- Division of Trauma, Burn and Critical Care Surgery, Harborview Medical Center, Seattle, Washington, USA
| | - Kathleen Moloney
- Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Douglas F Zatzick
- Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
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Jeong CH, Um MY, Yoo JP, Palinkas LA. Social networks and health-promoting behaviors among North Korean refugees in South Korea. Soc Work Health Care 2020; 59:738-750. [PMID: 33292084 DOI: 10.1080/00981389.2020.1859043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/20/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
Poor health behaviors among North Korean refugees (NKRs) in South Korea are serious risk factors hindering their overall well-being. Despite their significance, little is known about the roles of social networks in promoting health behaviors of NKRs. Thus, we examined how social network characteristics were associated with health-promoting behaviors among 202 NKRs. We found that social networks featuring members of religious organizations were positively associated with overall health-promoting behaviors, health responsibility, exercise, and nutrition, whereas networks with South Korean friends were negatively associated with nutrition. Findings suggest that health interventions facilitating religion-based network ties may promote health behaviors among NKRs.
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Affiliation(s)
- Chung Hyeon Jeong
- College of Health and Human Services, Department of Social Work, University of New Hampshire , Durham, New Hampshire, USA
| | - Mee Young Um
- Watts College of Public Service and Community Solutions, School of Social Work, Arizona State University , Phoenix, Arizona, USA
| | - Joan P Yoo
- Department of Social Welfare, Seoul National University , Seoul, South Korea
| | - Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California , Los Angeles, California, USA
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Dubowitz H, Saldana L, Magder LA, Palinkas LA, Landsverk JA, Belanger RL, Nwosu US. Protocol for comparing two training approaches for primary care professionals implementing the Safe Environment for Every Kid (SEEK) model. Implement Sci Commun 2020; 1:78. [PMID: 32974614 PMCID: PMC7506208 DOI: 10.1186/s43058-020-00059-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child maltreatment (CM) is a major public health problem, affecting many lives, in the short and long term, and costing individuals, families, and society dearly. There is a need for broad implementation of evidence-based preventive interventions, such as the Safe Environment for Every Kid (SEEK) model, developed for pediatric primary care. Primary care offers an excellent opportunity to help address prevalent psychosocial problems (e.g., parental depression) that are risk factors for CM. By addressing such problems, SEEK can strengthen families and support parents; promote children's health, development, and safety; help prevent CM; and benefit the health of the US population. This study will examine intervention strategies for optimizing SEEK's adoption, implementation, and sustainment, and its effectiveness in preventing CM.Despite strong evidence from two federally funded randomized controlled trials, SEEK has not been widely adopted. The goal of this study is to examine technology-driven implementation strategies to scale-up SEEK-in pediatric and family medicine primary care settings. The aims are to (1) evaluate the effectiveness of training strategies on SEEK's implementation in primary care practices, (2) evaluate barriers and facilitators to successful implementation and sustainment of SEEK, and (3) examine the model's effectiveness in preventing CM and the economic costs of implementing SEEK. METHODS This randomized type III hybrid mixed methods design will examine how advances in medical training can bolster SEEK's adoption and implementation in pediatric and family medicine practices in different regions of the USA. These are independent online training and in-depth structured training via a quality improvement project, approved by the American Boards of Pediatrics and of Family Medicine. We will also evaluate SEEKonline, software that assists primary care practitioners implement the model, and a "Traditional" paper and pencil strategy for their impact on implementation. The study uses the EPIS framework and the Universal Stages of Implementation Completion, quantitative measures, qualitative interviews, and data abstracted from electronic health records. DISCUSSION The knowledge gained should improve pediatric primary care to better address prevalent social determinants of health, benefiting many children and families. The outcomes should enhance the field of implementation science and guide future interventions in primary care. TRIAL REGISTRATION NCT03642327, Clinical Trials, registered August 21, 2018.
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Affiliation(s)
- Howard Dubowitz
- Division of Child Protection, Department of Pediatrics, University of Maryland School of Medicine, 520 W. Lombard St, Baltimore, MD 21201 USA
| | - Lisa Saldana
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401 USA
| | - Laurence A. Magder
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 655 W. Baltimore St., Baltimore, MD 21201 USA
| | - Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, MC0411, Los Angeles, CA 90089-0411 USA
| | - John A. Landsverk
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401 USA
| | - Rose L. Belanger
- Division of Child Protection, Department of Pediatrics, University of Maryland School of Medicine, 520 W. Lombard St, Baltimore, MD 21201 USA
| | - Ugonna S. Nwosu
- Division of Child Protection, Department of Pediatrics, University of Maryland School of Medicine, 520 W. Lombard St, Baltimore, MD 21201 USA
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Badal VD, Graham SA, Depp CA, Shinkawa K, Yamada Y, Palinkas LA, Kim HC, Jeste DV, Lee EE. Prediction of Loneliness in Older Adults Using Natural Language Processing: Exploring Sex Differences in Speech. Am J Geriatr Psychiatry 2020; 29:853-866. [PMID: 33039266 PMCID: PMC7486862 DOI: 10.1016/j.jagp.2020.09.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The growing pandemic of loneliness has great relevance to aging populations, though assessments are limited by self-report approaches. This paper explores the use of artificial intelligence (AI) technology to evaluate interviews on loneliness, notably, employing natural language processing (NLP) to quantify sentiment and features that indicate loneliness in transcribed speech text of older adults. DESIGN Participants completed semi-structured qualitative interviews regarding the experience of loneliness and a quantitative self-report scale (University of California Los Angeles or UCLA Loneliness scale) to assess loneliness. Lonely and non-lonely participants (based on qualitative and quantitative assessments) were compared. SETTING Independent living sector of a senior housing community in San Diego County. PARTICIPANTS Eighty English-speaking older adults with age range 66-94 (mean 83 years). MEASUREMENTS Interviews were audiotaped and manually transcribed. Transcripts were examined using NLP approaches to quantify sentiment and expressed emotions. RESULTS Lonely individuals (by qualitative assessments) had longer responses with greater expression of sadness to direct questions about loneliness. Women were more likely to endorse feeling lonely during the qualitative interview. Men used more fearful and joyful words in their responses. Using linguistic features, machine learning models could predict qualitative loneliness with 94% precision (sensitivity = 0.90, specificity = 1.00) and quantitative loneliness with 76% precision (sensitivity = 0.57, specificity = 0.89). CONCLUSIONS AI (e.g., NLP and machine learning approaches) can provide unique insights into how linguistic features of transcribed speech data may reflect loneliness. Eventually linguistic features could be used to assess loneliness of individuals, despite limitations of commercially developed natural language understanding programs.
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Affiliation(s)
- Varsha D Badal
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA
| | - Sarah A Graham
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA
| | - Colin A Depp
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; VA San Diego Healthcare System (CAD, EEL), La Jolla, CA
| | - Kaoru Shinkawa
- Accessibility and Aging, IBM Research-Tokyo (KS, YY), Tokyo, Japan
| | - Yasunori Yamada
- Accessibility and Aging, IBM Research-Tokyo (KS, YY), Tokyo, Japan
| | - Lawrence A Palinkas
- Suzanne Dworak Peck School of Social Work (LAP), University of Southern California, Los Angeles, CA
| | - Ho-Cheol Kim
- AI and Cognitive Software, IBM Research-Almaden (HCK), San Jose, CA
| | - Dilip V Jeste
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Department of Neurosciences (DVJ), University of California San Diego, La Jolla, CA
| | - Ellen E Lee
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; VA San Diego Healthcare System (CAD, EEL), La Jolla, CA.
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Palinkas LA, Chou CP, Spear SE, Mendon SJ, Villamar J, Brown CH. Measurement of sustainment of prevention programs and initiatives: the sustainment measurement system scale. Implement Sci 2020; 15:71. [PMID: 32883352 PMCID: PMC7470441 DOI: 10.1186/s13012-020-01030-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background Enhancing the sustainability of evidence-based prevention programs for mental and behavioral health requires tools for measuring both sustainability determinants and sustainment outcomes. The aim of this study was to develop the Sustainment Measurement System Scale (SMSS) and to assess its reliability and construct validity for measuring both determinants and outcomes of efforts to sustain prevention programs and initiatives. Methods A 42-item scale comprised of items identified from qualitative data collected from 45 representatives of 10 programs and 8 SAMHSA program officers was administered to 186 representatives of 145 programs funded by 7 SAMHSA prevention grant initiatives. Cronbach’s alphas were used to determine inter-item reliability. Convergent validity was assessed by comparisons of a global measure of sustainment with current SAMHSA-funding status and continued operation in the same form. Discriminant validity was assessed by comparisons of sustainability determinants with whether or not the program had undergone adaptations. Results Confirmatory factor analysis provided support for a 35-item model fit to the data. Cronbach’s alpha was .84 for the sustainment outcome construct and ranged from .70 to .93 for the sustainability determinant constructs. All of the determinant constructs were significantly associated with sustainment outcome individual and global measures for the entire sample (p < 0.01 to 0.001) and for community-based programs and programs with a substance abuse focus (p < 0.05 to 0.001). Convergent validity was supported by significant associations between the global sustainment measure and current SAMHSA funding status and continued operation in the same form (p < 0.001). Four of the sustainability determinant constructs (responsive to community needs; coalitions, partnerships, and networks; organizational staff capability; and evaluation, feedback, and program outcomes) were also significantly associated with current SAMHSA funding status (p < 0.5 to 0.01). With the exception of organizational staff capability, all sustainability determinants were unrelated to program adaptation as predicted. Conclusions The SMSS demonstrated good reliability and convergent and discriminant validity in assessing likelihood of sustainment of SAMHSA funded prevention programs and initiatives. The measure demonstrates potential in identifying predictors of program sustainment and as a tool for enhancing the likelihood of successful sustainment through ongoing evaluation and feedback.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
| | - Chih-Ping Chou
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Suzanne E Spear
- Department of Health Sciences, California State University, Northridge, CA, USA
| | - Sapna J Mendon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Juan Villamar
- Center for Prevention Implementation Methodology (Ce-PIM) for Drug Abuse and HIV, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - C Hendricks Brown
- Center for Prevention Implementation Methodology (Ce-PIM) for Drug Abuse and HIV, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Fenwick KM, Palinkas LA, Hurlburt MS, Lengnick-Hall RD, Horwitz SM, Hoagwood KE. Acquisition of Information About Innovative Practices in Outpatient Mental Health Clinics. Adm Policy Ment Health 2020; 47:752-763. [PMID: 32157474 PMCID: PMC7222893 DOI: 10.1007/s10488-020-01029-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study uses qualitative interviews with leaders of 34 mental health clinics in the context of a statewide rollout of clinical and business innovations to explore how clinics first learn about innovations and which external sources of information they access. Clinic leaders reported accessing information about innovations mainly from government agencies, professional associations, peer organizations, and research literature. Leaders mentioned an average of two external sources of information. There was evidence of variation in how leaders accessed information and how information about innovations was communicated within clinics. Findings have implications for improving dissemination of information about innovations in mental health systems.
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Affiliation(s)
- Karissa M Fenwick
- Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd (206), Los Angeles, USA.
| | - Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Michael S Hurlburt
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | | | - Sarah M Horwitz
- Department of Child and Adolescent Psychiatry, New York University, New York, NY, USA
| | - Kimberly E Hoagwood
- Department of Child and Adolescent Psychiatry, New York University, New York, NY, USA
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Rodriguez A, Kim JJ, Zhan C, Lau AS, Hamilton AB, Palinkas LA, Gellatly R, Brookman-Frazee L. A Mixed-Method Analysis on the Impacts of a System-Driven Implementation of Multiple Child Evidence-Based Practices on Community Mental Health Providers. ACTA ACUST UNITED AC 2020; 52:67-79. [PMID: 34349341 DOI: 10.1037/pro0000353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Initiatives to scale up evidence-based practices (EBPs) in routine care are likely to have myriad impacts on community providers, but these impacts have not yet been examined in depth. This is especially true within the context of simultaneous implementation of multiple evidence-based practices. The aim of this study was to characterize the multifaceted impacts on community mental health therapists within a system-driven implementation of multiple EBPs for youth and families. Semistructured interview and survey data were gathered from 60 therapists at 11 agencies contracted with the Los Angeles County Department of Mental Health to deliver EBPs within the Prevention and Early Intervention initiative. Therapists' accounts of impacts varied, and were either predominately negative, predominantly positive, or mixed-valence. Mixed-methods analyses using Kruskal-Wallis tests showed therapist valence groups varied on mean levels of self-reported burnout on surveys. Themes from qualitative data revealed several favorable (e.g., increased EBP knowledge, structure) and unfavorable (e.g., distress, feeling constrained by EBPs) impacts of county-contracted EBP implementation. These findings inform the development and implementation of future system-driven EBP initiatives that consider therapist perspective to optimize positive impacts and minimize negative impacts on therapists.
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Affiliation(s)
| | | | | | | | | | | | | | - Lauren Brookman-Frazee
- University of California, San Diego and San Diego State University/University of California, San Diego
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Palinkas LA, Wong M. Global climate change and mental health. Curr Opin Psychol 2020; 32:12-16. [DOI: 10.1016/j.copsyc.2019.06.023] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 01/06/2023]
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Palmer Molina A, Palinkas LA, Monro W, Mennen FE. Mothers' Perceptions of Help-Seeking for Depression in Head Start: A Thematic, Discourse Analysis by Language Group. Community Ment Health J 2020; 56:478-488. [PMID: 31686303 DOI: 10.1007/s10597-019-00504-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022]
Abstract
Maternal depression poses a threat to the well-being of poor minority mothers and their young children, but significant disparities remain in the access and utilization of treatment among this population in the United States. Providing group treatment in early childhood education settings like Head Start may be an effective way to address this public health concern. However, intervention developers would benefit from understanding potential barriers and facilitators to engagement with this population, particularly those related to cultural and linguistic differences. Focus groups were conducted to explore perceptions of help-seeking for depression among English and Spanish-speaking Head Start mothers as part of a larger effectiveness study. Thematic and discourse analysis strategies were used to examine similarities and differences across English and Spanish language groups. Results revealed similar and divergent concerns about broader environmental stressors and striking differences in the processes of group formation. Findings demonstrate the importance of addressing structural factors, developing flexible interventions, and tailoring interventions for both English-speaking and Spanish-speaking groups.
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Affiliation(s)
- Abigail Palmer Molina
- University of Southern California Suzanne Dworak-Peck School of Social Work, 669 W. 34th Street, Los Angeles, CA, 90089, USA.
| | - Lawrence A Palinkas
- University of Southern California Suzanne Dworak-Peck School of Social Work, 669 W. 34th Street, Los Angeles, CA, 90089, USA
| | - William Monro
- University of Southern California Suzanne Dworak-Peck School of Social Work, 669 W. 34th Street, Los Angeles, CA, 90089, USA
| | - Ferol E Mennen
- University of Southern California Suzanne Dworak-Peck School of Social Work, 669 W. 34th Street, Los Angeles, CA, 90089, USA
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Palinkas LA, Spear SE, Mendon SJ, Villamar J, Reynolds C, Green CD, Olson C, Adade A, Brown CH. Conceptualizing and measuring sustainability of prevention programs, policies, and practices. Transl Behav Med 2020; 10:136-145. [PMID: 31764968 PMCID: PMC7020391 DOI: 10.1093/tbm/ibz170] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. We interviewed 45 representatives of 10 grantees and 9 program officers within 4 Substance Abuse and Mental Health Services Administration prevention grant initiatives to identify experiences with implementation and sustainability barriers and facilitators; what "sustainability" means and what it will take to sustain their programs; and which Consolidated Framework for Implementation Research (CFIR) elements are important for sustainability. Lists of sustainability determinants and outcomes were then compiled from each data set and compared with one another. Analysis of themes from interviews and free lists revealed considerable overlap between sustainability determinants and outcomes. Four sustainability elements were identified by all three data sets (ongoing coalitions, collaborations, and networks and partnerships; infrastructure and capacity to support sustainability; community need for program; and ongoing evaluation of performance and outcomes), and 11 elements were identified by two of three data sets (availability of funding; consistency with organizational culture; evidence of positive outcomes; development of a plan for implementation and sustainment; presence of a champion; institutionalization and integration of program; institutional support and commitment; community buy-in and support; program continuity; supportive leadership; and opportunities for staff training). All but one of the CFIR domain elements (pressure from other states, tribes, or communities) were endorsed as important to sustainability by 50% or more of participants. It may be more important to implement a standardized process of eliciting determinants and outcomes of sustainability than to implement a single standardized instrument.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Suzanne E Spear
- Department of Health Sciences, California State University, Northridge, CA, USA
| | - Sapna J Mendon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Juan Villamar
- Center for Prevention Implementation Methodology (Ce-PIM) for Drug Abuse and HIV, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Reynolds
- Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA
| | - Costella D Green
- Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA
| | - Charlotte Olson
- Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA
| | - Audrey Adade
- Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA
| | - C Hendricks Brown
- Center for Prevention Implementation Methodology (Ce-PIM) for Drug Abuse and HIV, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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