scholarly journals Community Partners in Care: 6-Month Outcomes of Two Quality Improvement Depression Care Interventions in Male Participants

2017 ◽  
Vol 27 (3) ◽  
pp. 223 ◽  
Author(s):  
Pratik Mehta ◽  
Anthony Brown ◽  
Bowen Chung ◽  
Felica Jones ◽  
Lingqi Tang ◽  
...  
Keyword(s):  
Mental Health ◽  
Los Angeles ◽  
Technical Assistance ◽  
Cluster Randomized Trial ◽  
Future Research ◽  
Community Partners ◽  
South Los Angeles ◽  
Male Clients ◽  
Minority Men ◽  
Mental Wellness

<p><strong>Objective: </strong>Limited data exist on approaches to improve depression services for men in under-resourced communities. This article explores this issue using a sub-analysis of male participants in Community Partners in Care (CPIC). <strong></strong></p><p><strong>Design: </strong>Community partnered, cluster, randomized trial. </p><p><strong>Setting: </strong>Hollywood-Metropolitan and South Los Angeles, California. </p><p><strong>Participants: </strong>423 adult male clients with modified depression (PHQ-8 score≥10). </p><p><strong>Interventions: </strong>Depression collaborative care implementation using community engagement and planning (CEP) across programs compared with the more-traditional individual program, technical assistance (Resources for Services, RS). </p><p><strong>Main Outcomes Measured: </strong>Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), mental wellness, services utilization and settings. </p><p><strong>Results: </strong>At screening, levels of probable depression were moderate to high (17.5%- 47.1%) among men across services sectors. Intervention effects on primary outcomes (PHQ-8 score and MHRQL) did not differ. Men in CEP compared with RS had improved mental wellness (OR 1.85, 95% CI 1.00–3.42) and reduced hospitalizations (OR .40, 95% CI .16–.98), with fewer mental health specialty medication visits (IRR 0.33, 95% CI .15–.69), and a trend toward greater faith-based depression visits (IRR 2.89, 95% CI .99–8.45). </p><p><strong>Conclusions: </strong>Exploratory sub-analyses suggest that high rates of mainly minority men in under-resourced communities have high prevalence of depression. A multisector coalition approach may hold promise for improving community-prioritized outcomes, such as mental wellness and reduced hospitalizations for men, meriting further development of this approach for future research and program design.</p><p><em>Ethn Dis. </em>2017;27(3):223-232; doi:10.18865/ed.27.3.223 </p>

scholarly journals Community Partners in Care: 6- and 12-month Outcomes of Community Engagement versus Technical Assistance to Implement Depression Collaborative Care among Depressed Older Adults

2018 ◽  
Vol 28 (Supp) ◽  
pp. 339-348 ◽  
Author(s):  
Adriana Izquierdo ◽  
Michael Ong ◽  
Esmeralda Pulido ◽  
Kenmeth B. Wells ◽  
Marina Berkman ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Los Angeles ◽  
Randomized Trial ◽  
Collaborative Care ◽  
Technical Assistance ◽  
Cluster Randomized Trial ◽  
Community Partners ◽  
Individual Program ◽  
Mental Wellness ◽  
Cluster Randomized

Objective: Community Partners in Care, a community-partnered, cluster-randomized trial with depressed clients from 95 Los Angeles health and community programs, examined the added value of a community coalition approach (Community Engage­ment and Planning [CEP]) versus individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care in underserved communi­ties. This exploratory subanalysis examines 6- and 12-month outcomes among CPIC participants aged >50 years.Design: Community-partnered, cluster-randomized trial conducted between April 2010 and March 2012.Setting: Hollywood-Metropolitan (HM) and South Los Angeles (SLA) Service Planning Areas (SPAs), Los Angeles, CaliforniaParticipants: 394 participants aged >50 years with depressive symptoms (8-item Patient Health Questionnaire score ≥ 10).Intervention: A community-partnered multi-sector coalition approach (Com­munity Engagement and Planning [CEP]) vs individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care.Main Outcome Measures: Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), commu­nity-prioritized outcomes including mental wellness, homelessness risk and physical activity, and services utilization.Results: At 6 months, CEP was more ef­fective than RS at improving MHRQL and mental wellness among participants aged >50 years; no differences were found in the effects of CEP vs RS on other outcomes. No significant outcome differences between CEP and RS were found at 12 months.Conclusions: A multisector community coalition approach may offer additional benefits over individual program tech­nical assistance to improve outcomes among depressed adults aged >50 years living in underserved communi­ties. Ethn Dis.2018;28(Suppl 2):339-348; doi:10.18865/ed.28.S2.339.

Abstract 53: Results Of The Nashville Barber-pharmacist Hypertension Management Pilot Study

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Jarod Parrish ◽  
Ciantel A Blyler ◽  
Henry E Okafor ◽  
L. Cindy Chang ◽  
Devika Nair ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
Los Angeles ◽  
Care Delivery ◽  
Medication Management ◽  
Lessons Learned ◽  
Future Research ◽  
Hypertension Management ◽  
Male Clients ◽  
Community Stakeholders

Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated that collaboration between barbers and pharmacists delivering hypertension management could significantly improve blood pressure as well as access to care. It is unknown if this model can be translated to other locations. This single-arm, proof-of-concept pilot study tested the development and implementation of a similar protocol in Nashville, TN (NCT04232124). Methods: Between 2019 and 2021, community stakeholders, clinicians, investigators, and the LABBPS team convened to adapt the study design and protocol. Established barbershops with barbers willing to be trained on study procedures were recruited as study sites. Non-Hispanic Black male clients, aged 35-79 years with systolic blood pressure (SBP) > 140 mmHg on two screening days were eligible for participation. Enrolled participants met with a pharmacist for lifestyle and medication management at least once monthly for a six-month period. Barbers measured blood pressure during haircuts for additional monitoring. Results: Eight barbershops in business for an average of 20 (± 5) years participated in the trial. Barbers from each shop (range: 1-4) were trained. A total of 419 clients completed screening visit 1, 82 were eligible and 52 (12%) completed visit 2. We enrolled 36, with 30 completing the initial clinical visit and 27 had complete data at 6-months. Participants were on average age 50 (± 10) years, had a body mass index 33 (± 6), 44% were currently smoking, 52% with high school or less education, and 56% reported current primary care. Baseline BP 157.7±17.1/ 95.1±13.9 mmHg improved to 125.7±11.9/75.6±9.5, a change of -32.1±21.6/ -19.5±14.1, respectively. At 6-months 85% of the group had a BP<140/90, 74% BP<135/85, and 67% BP<130/80. At baseline 15% of participants reported health as excellent/very good and this increased to 56% at 6-months (p=0.002). Adverse reactions reported were minimal. Conclusion: Implementation of the barber-pharmacist model of hypertension management and care delivery improved BP control among hypertensive Black men in Nashville. Lessons learned regarding adaptation overcoming unforeseen barriers will inform expansion into additional naïve locations for future research.

scholarly journals Community Engagement and Planning versus Resources for Services for Implementing Depression Quality Improvement: Exploratory Analysis for Black and Latino Adults

2019 ◽  
Vol 29 (2) ◽  
pp. 277-286
Author(s):  
Nicolás E. Barceló ◽  
Alma Lopez ◽  
Lingqi Tang ◽  
Maria Gabriela Aguilera Nunez ◽  
Felica Jones ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Quality Improvement ◽  
Community Engagement ◽  
Technical Assistance ◽  
Care Quality ◽  
Depression Care ◽  
Latino Adults ◽  
Mental Wellness ◽  
Black And Latino

Objective: Racial/ethnic minorities experi­ence disparities in depression1 and there is a paucity of evidence-based interventions to improve depression care access and outcomes. Community Partners in Care (CPIC) is a community-partnered study of depression care quality improvement (QI) in under-resourced, urban communities: Community Engagement and Planning (CEP) for multi-sector coalitions, and Resources for Services (RS) for program technical assistance.2 CEP demonstrated benefits for the overall CPIC study population; effects for Black and Latino sub-populations are unknown.Methods: This sub-analysis examines outcomes for 409 Latino and 488 Black (non-Latino) adults recruited from 90 pro­grams who completed baseline or 6-month follow-up. Regression analyses were used to estimate CEP vs RS intervention effects on primary (Mental Health Related Quality of Life [MHRQL], Patient Health Question­naire-9 [PHQ-9]) and community-priori­tized (mental wellness, physical activity, risk for homelessness) outcomes at 6-months.Results: Baseline characteristics did not differ significantly by intervention in either group. In the adjusted analysis for Black adults, CEP resulted in decreased odds of poor MHRQL (OR: .62, 95% CI=.41- .94, P=.028) with a trend for reducing homelessness risk (OR: .60, .35-1.05, P=.69). For Latino adults, CEP resulted in greater probability of mental wellness (OR: 1.81, 1.05-3.13, P=.034) and a trend for increased physical activity (OR: 1.52, .93- 2.49, P=.091).Conclusions: Exploratory analyses of CEP for depression quality improvement sug­gests significant 6-month benefits in mental health outcomes for Black and Latino participants and trends for improvement in community-prioritized outcomes for both groups. Findings may inform research in multi-sector coalitions to promote equity in depression care. Ethn Dis. 2019;29(2):277- 286; doi:10.18865/ed.29.2.277

Gender and Serious Mental Illness: A Feminist Perspective

1992 ◽  
Vol 16 (1) ◽  
pp. 107-126 ◽  
Author(s):  
Carol T. Mowbray ◽  
Sandra E. Herman ◽  
Kelly L. Hazel
Keyword(s):  
Mental Health ◽  
Mental Illnesses ◽  
Gender Composition ◽  
Future Research ◽  
Male Clients ◽  
Problem Formulations ◽  
Serious Mental Illnesses ◽  
Female Clients ◽  
Statistical Clustering

Perhaps in reaction to criticisms of “woman as problem” formulations, psychological literature has nearly ignored women with serious mental illnesses (SMI), although epidemiological research indicates that women are overrepresented in these diagnoses. Data are presented on characteristics, functioning, and services received for a sample of nearly 2,500 SMI clients. Statistical clustering of clients with similar profiles produced four out of six clusters with significant differences in proportions of female versus male clients represented. The results indicate that the extent to which SMI clients display gender-related symptoms and behaviors is a significant factor in clinician perceptions and in service utilization. However, results also show substantial overlap in gender composition of the clusters. Discussion centers on the quality of care and appropriateness of services for female clients. Future research is suggested, utilizing a feminist understanding of women's diversity and of sociopolitical factors related to mental health.

Indigenous American/Two-Spirit Mental Health

2020 ◽  
pp. 207-220
Author(s):  
Naomi Bird ◽  
Margaret Robinson
Keyword(s):  
Mental Health ◽  
Negative Impact ◽  
Boarding School ◽  
Future Research ◽  
Key Factors ◽  
Culturally Informed ◽  
Two Spirit ◽  
Mental Wellness ◽  
Anxiety Depression ◽  
Minority People

While many Indigenous languages have terms for individuals who combine masculinity with femininity in some way, Indigenous gender minority people have increasingly come to self-identify using the pan-Indigenous term “two-spirit.” This chapter examines key factors shaping the mental wellness of two-spirit people, such as the negative impact of residential and boarding school incarceration, and highlights available data on anxiety, depression, posttraumatic stress disorder, suicidality, and substance use. Reducing the mental health disparities that two-spirit people face is made more challenging by the lack of culturally informed and supportive health services. The authors describe factors that may buffer the minority stressors that lead to negative mental health outcomes and may increase wellness. The chapter concludes with a discussion of promising directions for future research.

scholarly journals Effects of the Anti-stigma Workplace Intervention “Working Mind” in a Canadian Health-Care Setting: A Cluster-Randomized Trial of Immediate Versus Delayed Implementation: Effets d’une intervention en milieu de travail anti-stigmates, l’Esprit au travail, dans un milieu canadien de soins de santé: un essai randomisé en grappes d’une mise en œuvre immédiate plutôt que reportée

2020 ◽  
pp. 070674372096173
Author(s):  
Keith S. Dobson ◽  
Veronika Markova ◽  
Alainna Wen ◽  
Laura M. Smith
Keyword(s):  
Mental Health ◽  
Cluster Randomized Trial ◽  
Past Research ◽  
Future Research ◽  
Mental Health Stigma ◽  
Control Group ◽  
Essai Randomisé ◽  
Program Effects ◽  
Cluster Randomized

Objectives: The Working Mind is a program designed to reduce stigmatizing attitudes toward mental illness, improve resilience, and promote mental health in the general workplace. Previous research has revealed positive program effects in a variety of workplace settings. This study advances previous work in implementing randomization and a control group to assess the intervention’s efficacy. Methods: The program was evaluated using a cluster-randomized design, with pretest, posttest, and a 3-month follow-up in 2 implementation groups across 4 sites. Results: The Working Mind program was effective at decreasing mental health stigma and increasing self-reported resilience and coping skills at the pre–post assessment in both delivery groups. The program’s effects were maintained to the time of 3-month follow-up. Qualitative data provided further evidence that participants benefited from the program. Conclusions: This study represents an advancement over past research and provides further support for efficacy of the Working Mind program. Directions for future research, including replication using rigorous methodological procedures and examination of program effects over longer follow-up intervals, are discussed.

Depression, Anxiety, and Alcohol Use Among LGBTQ+ People During the COVID-19 Pandemic

2021 ◽  
pp. e1-e10
Author(s):  
Ellesse-Roselee Akré ◽  
Andrew Anderson ◽  
Kristefer Stojanovski ◽  
Kara W. Chung ◽  
Nicole A. VanKim ◽  
...  
Keyword(s):  
Mental Health ◽  
New York ◽  
Sexual Behavior ◽  
Sexual Orientation ◽  
Los Angeles ◽  
Gender Identity ◽  
Problem Drinking ◽  
Future Research ◽  
And Gender ◽  
The Impact

Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were “more than usual” during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts. (Am J Public Health. Published online ahead of print August 19, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306394 )

scholarly journals Whole Person Care in Underresourced Communities: Stakeholder Priorities at Long-Term Follow-Up in Community Partners in Care

2018 ◽  
Vol 28 (Supp) ◽  
pp. 371-380 ◽  
Author(s):  
Dmitry Khodyakov ◽  
Mienah Zulfacar Sharif ◽  
Felica Jones ◽  
S. Megan Heller ◽  
Esmeralda Pulido ◽  
...  
Keyword(s):  
Mental Health ◽  
Needs Assessment ◽  
Service Providers ◽  
Cluster Randomized Trial ◽  
Social Needs ◽  
Coalition Building ◽  
Physical And Mental Health ◽  
Community Partners ◽  
Whole Person ◽  
Improvement Programs

Objective: Depressed individuals may require help from different agencies to ad­dress health and social needs, but how such coordination occurs in under-resourced communities is poorly understood. This study sought to identify priorities of Latino and African American depressed clients, ex­plore whether service providers understand client priorities, and describe how providers address them.Methods: Between October 2014 and February 2015, we interviewed 104 clients stratified by depression history and 50 representatives of different programs in health and social community agencies who participated in Community Partners in Care, a cluster-randomized trial of coalition-building approaches to delivering depres­sion quality improvement programs. Clients were queried about their most pressing needs; program representatives identified their clients’ needs and explained how they addressed them.Results: Physical and mental health were clients’ top priorities, followed by housing, caring for and building relationships with others, and employment. While persistently depressed clients prioritized mental health, those with improved depression prioritized relationships with others. Program repre­sentatives identified housing, employment, mental health, and improving relationships with others as clients’ top priorities. Needs assessment, client-centered services, and linkages to other agencies were main strate­gies used to address client needs.Conclusion: Depressed clients have mul­tiple health and social needs, and program representatives in under-resourced commu­nities understand the complexity of clients’ needs. Agencies rely on needs assessment and referrals to meet their clients’ needs, which enhances the importance of agency partnership in “whole person” initiatives. Our results illustrate agency capacity to adopt integrated care models that will ad­dress clients’ multiple needs through multi-sector collaboration and describe potential strategies to help reach the goal of whole person care.Ethn Dis. 2018;(Suppl 2): 371- 380; doi:10.18865/ed.28.S2.371.

scholarly journals Training Community Pharmacy Staff How to Help Manage Urgent Mental Health Crises

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 133 ◽  
Author(s):  
Nathaniel Rickles ◽  
Albert Wertheimer ◽  
Yifan Huang
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Pharmacy Practice ◽  
Health Needs ◽  
Future Research ◽  
Mental Health Needs ◽  
Pharmacy Staff ◽  
Stigma Of Mental Illness ◽  
Mental Wellness ◽  
Education Support

Nearly 44 million Americans are affected by mental illness every year. Many individuals, however, are not diagnosed and/or do not receive treatment. The present manuscript reviews the incidence of mental illness, the continuum from mental wellness to mental illness, and the role of the pharmacy staff in helping individuals manage different mental health needs. In particular, there is discussion of stigma of mental illness that those with mental health needs experience by those around them including health professionals such as pharmacy staff. One way to resolve such stigma is through training such as Mental Health First Aid (MHFA). The paper reviews key aspects of MHFA, the evidence supporting MHFA, and how MHFA relates specifically to pharmacy practice and services. A conceptual framework for MHFA and its relationship to individual factors, attitudes, behaviors, and outcomes. Lastly, a discussion is presented that briefly compares MHFA to other similar approaches to helping those in mental health crises, the limits of what is known about MHFA, and what future research might explore to better understand the outcomes of pharmacy staff providing mental health education, support, and referral to care.

Physical and Psychological Benefits of Written Emotional Expression

2015 ◽  
Vol 20 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Éva Kállay
Keyword(s):  
Mental Health ◽  
Expressive Writing ◽  
Mental Health Problems ◽  
Cost Effective ◽  
Health Problems ◽  
Future Research ◽  
Psychological Benefits ◽  
Cost Effective Treatment ◽  
Meta Analyses

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.

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