Center for Applied Health Research (CAHR)

 

Brief description of project goals

This study will: (1) describe the development and implementation of Homefront services; and (2) assess the association of Homefront counseling services with change in symptoms.

Funders

Scott & White Research Mentor Award

Funding Period

2013-2014

Selected Publications

Williams DM, Tsan JY, Trent ME, Copeland LA. Implementation of a community psychological treatment program for military families: Project Homefront. Int J Soc Sci Humanit Invent 2016; 3(4):1952-1960

Brief description of project goals

Suicide is a leading cause of death in children and adolescents and a critical public health concern. One promising suicide prevention strategy that is under-utilized includes restricting access to lethal means. Firearms are an important target given that 1 in 3 homes possess a firearm, the most lethal manner by which suicide is attempted. The Safety Check intervention is an evidence-based practice for implementing firearms means restriction in pediatric primary care recommended by the American Academy of Pediatrics. Yet providers rarely discuss means restriction or firearms during visits, suggesting we need to better understand barriers and facilitators of such interventions. The NIMH-funded Mental Health Research Network (MHRN) affords a unique opportunity for understanding how to implement means restriction in pediatric primary care from a system-level perspective. Our primary objectives: Aim 1: survey primary care providers and clinical leadership within two healthcare systems to understand acceptability and use of the three Safety check components (i.e., screening, brief counseling around gun safety, and provision of gunlocks). Aim 2: use intervention mapping to evaluate qualitative interviews with a few individuals at each site to gauge their insights about means restriction, feasibility of potential interventions, and other considerations. The ultimate goal of a planned successive proposal is to systematically develop and evaluate a multi-level menu of implementation strategies for firearm means restriction in pediatric primary care.

Collaborators

• BSW site lead: Zeber, John, PhD
• Henry Ford Health System (MHRN)
• University of Pennsylvania

Funders

Funders: National Institute of Mental Health (R21)

Funding Period

Funding Period: May 2016 – May 2018

Selected Publications

• Beidas RS, Jager-Hyman S, Becker-Haimes EM, Wolk CB, Ahmedani BK, Zeber JE, Fein JA, Brown GK, Lieberman A, Gregor CA, Marcus SC. “Acceptability and use of evidence-based practices to promote safe firearm storage in pediatric primary care for suicide prevention: a survey in two health systems”. [manuscript under review; JAMA Internal Medicine]
• Wolk CB, Jager-Hyman S, Marcus SC, Ahmedani BK, Zeber JE, Fein JA, Brown GK, Lieberman A, Beidas RS. (2017). “Developing implementation strategies with stakeholders to promote firearm safety as a suicide prevention strategy in pediatric primary care”. BMJ Open, v7:e1044067.
• Early implementation experiences and preliminary study findings have been presented at several meetings or professional conferences in 2016-2017: e.g., MHRN steering committee, APA national research meeting, BSW research day, Society for Suicide Prevention meeting, others

Brief description of project goals

The United Way of Tarrant County launched the Live Well initiative in 2010. Live Well initiative is implemented through various impact grants aimed to improve the lives of 17,000 adults with ongoing health concerns by the year 2020. The goal of the Live Well initiative is to implement strategies that will help people with chronic disabling conditions and their caregivers live well, in the community, for a longer period of time. The strategies help older adults remain at home, some with the support of family caregivers, to avoid institutional placement and hospitalizations and to improve the individual's capacity for disease self-management.

The objective of the evaluation is to conduct an independent summative and formative evaluation of the implementation, effectiveness and impact of the Live Well Health Initiative.

• The evaluation will track progress of funded organizations toward achieving defined milestones.
• The evaluation will assess client status on standardized outcome measures before and after services delivered.
• The evaluation will address the degree to which the funding model and strategies are working to improve the health of adults in Tarrant County, TX.

Collaborators

• Sixty and Better Inc. (Formerly, Senior Citizen Services)
• Meals on Wheels Inc. of Tarrant County
• North Texas Area Community Health Center
• Alzheimer's Association - North Central Texas Chapter
• Easter Seals North Texas – Fort Worth Center

Funders

United Way of Tarrant County, TX

Funding Period

7/1/12 – present

Selected Publications

• Stevens AB, Ory MG, Cho J, & Thorud JL (2013 – present). Live Well (formerly: Healthy aging and independent living) initiative evaluation. Quarterly reports, Temple, TX.
• Selected Presentations:
• Cho J, Thorud JL, & Stevens AB (2015, November). Lessons learned from the evaluation of the HAIL initiative. Presented at the Gerontological Society of America's Annual Meeting, Orlando, FL.

Brief description of project goals

United Way of Tarrant County (UWTC) and collaborators propose to enhance current system to create a Model for Alzheimer's/Dementia Services (MAS). The goal of MAS is to expand the existing dementia-capable system services and supports to increase access to culturally sensitive evidence-based support services to the unserved and underserved population who either have or are at high risk of developing Alzheimer's Disease and Related Dementias (ADRD) and their caregivers (CGs).

The objective of evaluation is to conduct an independent summative and formative evaluation of the implementation, effectiveness and impact of the Model for Alzheimer's/Dementia Services (MAS) by tracking progress of services and support toward achieving defined milestones.

Collaborators

• Aging & Disability Resource Center Tarrant County (ADRC)
• UNT Health Science Center
• Alzheimer's Association-North Central Texas Chapter (AA)
• Easter Seals North Texas (ES)
• James L. West Alzheimer's Center (JLW)
• Meals on Wheels Inc. of Tarrant County (MOW)
• Mental Health Mental Retardation of Tarrant County (MHMR)
• University of Arlington at Texas (UAT)
• WellMed Charitable Foundation

Funders

The United Way of Tarrant County

Funding Period

9/1/16 – 8/31/18

Brief description of project goals

EHFC incorporates evidence-based and evidence-informed care for Heart Failure into a practical, structured approach based on the concept of patient engagement and empowerment within the context of team-based care. This project will develop and evaluate a patient-centered, multi-disciplinary, team-based program for the support of Heart Failure patients

Participants

• Baylor University
• Baylor Scott & White Health- North

Funders

Collaborative Faculty Research Investment Program (CFRIP)

Funding Period

3/20/2017-11/17/2017

Selected Publications

Abraham S, Beck H, Day J, Sanghi S, & Stevens AB. (2017, April). Impact of engagement in heart failure care (EHFC) intervention in heart failure patients at Baylor Scott & White Health. Presented at Baylor Scott & White Health Research Day, Temple, TX.

Brief description of project goals

Texas A&M Program on Healthy Aging (PHA) is working with Baylor Scott & White Health (BSWH) on the SUSTAIN project. This project serves as a central hub to embed a suite of Stanford Patient Education Chronic Disease Self-Management Program (CDSMP), Diabetes Self-Management Program (DSMP) and Chronic Pain Self-Management Program within a 59 county region in Central and East Texas to strengthen and support the Area Agency on Aging (AAA) services as a sustainable and reimbursable model. BSWH will be expanding their reach and capacity through marketing and identification of chronically-ill patients in order to empower their patients to better manage their chronic conditions through these workshops.

Collaborators

• Texas A&M Program on Healthy Aging (PHA)
• Area Agency on Aging (AAA)

Funders

Administration for Community Living (ACL)

Funding Period

2016-2018

Brief description of project goals

Toyota SI Partnerships is an effort to make impact on the capacity of the organization to more effectively and holistically serve older adults and persons with disabilities. Partnering with two local Meals on Wheels (MOWA), this project will enhance Toyota's competitive advantage as it builds on the known intervention of volunteer driving programs; and provides an opportunity to accumulate knowledge about how on demand solutions might integrate and enhance volunteer engagement, foster mobility coordination, and identify new markets for on demand solutions and assistive technology.

The goal of the evaluation is to 1) work with project stakeholders to create a framework to guide evaluation of the app and web-based platforms, 2) assist the platform development team with selection of specific measures and indicators needed to demonstrate the value of the platforms and the outcomes achieved from home delivered meals, 3) conduct an evaluation of the app and web-based platform, and 4) contribute to the design and execution of the dissemination plan.

Partners

• Meals on Wheels, Collin County
• VNA Meals on Wheels

Funders

Toyota Motor North America

Funding Period

10/1/17 – 3/31/19

Related Publications

• Cho J, Throud JL, Marishak-Simon S, Hammack L, & Stevens AB. (in press) Frequency of hospital use before and after home-delivery meal by Meals On Wheels, of Tarrant County, Texas. The Journal of Nutrition, Health & Aging.
• Cho J, Throud JL, Marishak-Simon S, Frwaley L, & Stevens AB. (2015). A model home-delivered meals program to support transitions from hospital to home. Journal of Nutrition in Gerontology and Geriatrics, 34(2), 207-217. doi: 10.1080/21551197.2015.1031598

Related Presentations

• Cho J, Throud JL, Marishak-Simon S, Frwaley L, & Stevens AB. (2015, November). A model home-delivered meals program to support transitions from hospital to home. Presented at the Gerontological Society of America's Annual Meeting, Orlando, FL.

Texas ADRC Evidence-Based Care Transition Intervention (CTI) Program

Brief description of project goals

This project is designed to reduce hospital readmissions by educating and empowering patients to manage their healthcare needs and bridge the gaps in care that often occur during the transition from hospital to home. Baylor Scott & White worked with the Central Texas ADRC to accomplish the following three objectives:

• 1. To expand patient access to CTI by offering the intervention to a larger, more diverse group of older adults at high risk of preventable re-hospitalizations at Scott & White Memorial Hospital, and implementing the intervention at Metroplex hospital in Killeen, Texas.
• 2. To increase the capacity of Central Texas ADRC partner organizations to offer CTI by training and certifying additional Central Texas ADRC staff as CTI coaches.
• 3. To increase the widespread dissemination of CTI training and certification to eight additional Texas ADRCs not currently offering CTI by serving as a Texas training site for CTI, and also as a resource for strategies and tools that promote implementation of CTI.

Participants

Central Texas ADRC

Funders

Administration on Aging

Funding Period

October 2010 – September 2013

Selected Publications

• Smith ER, & Stevens AB. Predictors of discharges to a nursing home in a hospital-based cohort. J Am Med Dir Assoc. 2009 Nov;10(9):623-9. doi: 10.1016/j.jamda.2009.06.003. PubMed PMID: 19883884.
• Perry A & Stevens AB. How do we make the business case for transitions? Generations 2012-2013 Winter; 36(4):71-77.
• Stevens AB, Hochhalter, AK, Basu R, Smith ER, Thorud JL, Jo C, & McGhee, R. A model program of community-based supports for older adults at risk of nursing home placement. J Am Geriatr Soc. 2015;63(12): 2601-2609.

Brief description of project goals

Community organizations are an excellent delivery channel for evidence-based programs (EBPs). However, it is often challenging for them to access and implement EBPs that match their clients' needs. In response, we developed a web-based interactive toolkit, EvidenceToPrograms.com, to serve as a user-friendly guide to select, implement, and evaluate EBPs. Divided into two sections, (1) selecting a suitable EBP and (2) implementing EBPs

with fidelity, the Toolkit provides a comprehensive overview of EBP's that can benefit community organizations, healthcare professionals, and students alike. The Toolkit also guides the user through a series of steps to facilitate an organization's understanding of their ability to deliver evidence-based programming with model fidelity. The Toolkit has several unique features such as rich content with supporting diagrams and tables, links to external sites for additional information and resources, and interactive Readiness Questions that help foster organizational readiness to implement an EBP. The Toolkit also offers strategies that can help organizations increase the sustainability of their implemented program. Other features of the Toolkit include expert videos and an FAQ section where users can submit their questions regarding EBPs.

Funders

National Institute on Aging

Funding Period

June 2010 - May2013

Selected Publications

• Stevens, A.B., Coleman, S.B., McGhee, R., & Ory, M.G. EvidenceToPrograms.com: A toolkit to support evidence-based programming for seniors. Frontiers in Public Health, 27(3):18; 2015.

Selected Presentation

• Stevens, A.B., Ory, M., McGhee, R. (2017, July). EvidenceToPrograms.com: Tool-kit for Identifying, Selecting and Implementing Evidence-Based Programs. Presented at the 21st IAGG World Congress of Gerontology and Geriatrics, San Francisco, CA.

Mental Health Research Network II (MHRN; Group Health primary site)

Brief description of project goals

The Mental Health Research Network renewal, MHRN II, continues the work of the consortium of 11 integrated care systems across the United States started in 2009 to develop novel methods and EMR-integrated infrastructure, and to conduct system-focused research in mental health including acute-phase depression treatment, behavioral activation psychotherapy for depression in pregnancy, Autism Spectrum Disorder (registry development), and the effect of FDA advisories on suicide risk in relation to antidepressant prescribing practices.

Participants

Kaiser-Permanente Washington (formerly Group Health Cooperative), Kaiser-Permanente Georgia, Kaiser-Permanente Hawaii, Kaiser-Permanente Northwest, Kaiser-Permanente Northern California, Kaiser-Permanente Southern California, Kaiser-Permanente Colorado, Essentia Institute of Rural Health, Health Partners Institute for Education and Research, Harvard Pilgrim Health Care Institute, Henry Ford Health System, Palo Alto Medical Foundation Research Institute.

Funders

National Institute of Mental Health

Funding Period

Aug 2014 – Jul 2019

Selected Publications

• Lu C, Zhang F, Lakoma MD, Madden JM, Rusinak D, Penfold RB, Simon G, Ahmedani BK, Clarke G, Hunkeler EM, Waitzfelder B, Owen-Smith A, Raebel MA, Rossom R, Colemen KJ, Copeland LA, Soumerai SB. Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. BMJ 2014;348:g3596. doi: 10.1136/bmj.g3596. PMID 24942789
• Ahmedani BK, Stewart C, Simon GE, Lynch F, Lu CY, Waitzfelder BE, Solbert LI, Owen-Smith A, Beck A, Copeland LA, Hunkeler EM, Rossom RC, Williams LK. Racial/ethnic differences in healthcare visits made prior to suicide attempt across the United States. Med Care 2015, 53(5): 430-435. PMID: 25872151.
• Coleman KJ, Stewart C, Waitzfelder BE, Zeber JE, Morales LS, Ahmed AT, Ahmedani BK, Beck A, Copeland LA, Cummings JR, Hunkeler EM, Lindberg NM, Lynch F, Lu CY, Owen-Smith AA, Trinacty CM, Whitebird RR, Simon GE. Racial-ethnic differences in psychiatric diagnoses and treatment across 11 health care systems in the Mental Health Research Network. Psychiatr Serv. 2016 Jul 1;67(7):749-57. doi: 10.1176/appi.ps.201500217. PMID: 27079987.
• Zeber JE, Coleman KJ, Fischer H, Yoon T, Ahmedani BK, Beck A, Hubley S, Imel Z, Rossom R, Shortreed S, Stewart C, Waitzfelder BE, Simon G. The impact of patient, provider, and systems factors on primary adherence rates to formal psychotherapy. Depression & Anxiety 2017 Sep 28 in press.

Brief description of project goals

Working with the Henry Jackson Foundation, the longitudinal study will determine trajectories of well-being among veterans exiting full-time military service, their use of programs to assist with transition from military to civilian life and reintegration into their communities, and components of programs associated with better or worse transition into civilian life after military service.

Funders

Veterans Health Administration – Health Services Research & Development; Henry Jackson Foundation for the Advancement of Military Medicine – Center for Public-Private Partnerships; Bob Woodruff Foundation; Health Net Federal Services; The Heinz Endowments; Lockheed Martin Corporation; May and Stanley Smith Charitable Trust; National Endowment for the Humanities; Northrop Grumman; Philip and Marge Odeen; Prudential; Robert R. McCormick Foundation; Rumsfeld Foundation; Schultz Family Foundation; Walmart Foundation; Wounded Warrior Project, Inc.

Funding Period

2015-2020

Brief description of project goals

The pilot project will determine whether opioid analgesic use (OAU) duration and dose increase the risk of a new episode of depression, depression relapse following successful pharmacotherapy, and refractory depression, among VA and non-federal private not-for-profit health care system patients

Participants

Saint Louis University; Henry Ford Health System.

Funders

National Institute of Mental Health

Funding Period

Sep 2014 – Aug 2016

Selected Publications

• Scherrer JF, Salas J, Copeland LA, Stock EM, Ahmedani BK, Sullivan M, Burroughs T, Schneider FD, Bucholz KK, Lustman PJ. Prescription opioid duration, dose, and increased risk of depression in 3 large patient populations. Ann Fam Med 2016 Jan-Feb;14(1):54-62. doi: 10.1370/afm.1885. PMID: 26755784
• Scherrer JF, Salas J, Copeland LA, Stock EM, Schneider FD, Sullivan M, Bucholz KK, Burroughs T, Lustman PJ. Increased risk of depression recurrence after initiation of prescription opioids in noncancer pain patients. Journal of Pain 2016 Apr;17(4):473-82. doi: 10.1016/j.jpain.2015.12.012. Epub 2016 Feb 13. PMID: 26884282.
• Scherrer JF, Salas J, Sullivan MD, Schneider FD, Bucholz KK, Burroughs T, Copeland LA, Ahmedani B, Lustman PJ. The influence of prescription opioid use duration and dose on development of treatment resistant depression. Preventive Medicine 2016; 91:110-116. doi: 10.1016/j.ypmed.2016.08.003. PMID 27497660.
• Salas J, Scherrer JF, Ahmedani BK, Copeland LA, Bucholz K, Sullivan M, Schneider F?D, Burroughs T, Lustman P. Adherence to antidepressants may be beneficial in reducing long-term prescription opioid use. Brit J Psychiatry. In press 22-SEP-2017.

Selected Presentations

• J Salas, J Scherrer, L Copeland, B Ahmedani, K Bucholz, M Sullivan, T Burroughs, D Schneider, P Lustman. "Gender Differences in the Association of Opioid Duration and New Depression Episode". North American Primary Care Research Group (NAPCRG) Annual Meeting, November 17-21, 2017, Montreal QC, Canada.
• J Scherrer, J Salas, M Sullivan, L Copeland, B Ahmedani, K Bucholz, D Schneider, T Burroughs, P Lustman. "Increased Prescription Opioid Cessation Following Adherence to Antidepressant Treatment". North American Primary Care Research Group (NAPCRG) Annual Meeting, November 17-21, 2017, Montreal QC, Canada.

Brief description of project goals

A multicomponent advance care planning program for people with serious illness living in nursing homes. PfC engages key stakeholders in a collaborative process of procedure revision to support advance care planning (ACP). We expect PfC to improve health care for older adults living in nursing homes in three ways: improve nursing home staff's understanding of palliative care principles, establish an ACP program that will honor patient (and family caregiver) preferences at the appropriate time, and reduce potentially inappropriate medical care by enhancing the relationship and the communication between care providers in the nursing home and hospital.

Participants

Scott & White Palliative Care Services

Funders

University of Colorado, Denver

Funding Period

1/20/2017-1/20/2018

Selected Publications