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

scholarly journals Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support

2015 ◽  
Vol 66 (8) ◽  
pp. 831-839 ◽  
Author(s):  
Bowen Chung ◽  
Victoria K. Ngo ◽  
Michael K. Ong ◽  
Esmeralda Pulido ◽  
Felica Jones ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Randomized Trial ◽  
Community Engagement ◽  
Technical Support ◽  
Care Quality ◽  
Depression Care

scholarly journals Shifting to Remotely Delivered Mental Health Care: Quality Improvement in the COVID-19 Pandemic

2020 ◽  
Vol 1 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Patrick Daigle ◽  
Abraham Rudnick
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Improvement ◽  
Mental Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Health Clinic ◽  
Quality Improvement Initiative ◽  
Service Users ◽  
Specialized Mental Health

This paper presents an organizational (ambulatory) case study of shifting mental health care from in-person to remote service delivery due to the current (COVID-19) pandemic as a rapid quality improvement initiative. Remotely delivered mental health care, particularly using synchronous video and phone, has been shown to be cost-effective, especially for rural service users. Our provincial specialized mental health clinic rapidly shifted to such remote delivery during the current pandemic. We report on processes and outputs of this rapid quality improvement initiative, which serves a purpose beyond pandemic circumstances, such as improving access to such specialized mental health care for rural and other service users at any time. In conclusion, shifting specialized mental health care from in-person to remotely delivered services as much as possible could be beneficial beyond the current pandemic. More research is needed to optimize the implementation of such a shift.

scholarly journals A qualitative study of urban hospital transitional care

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Joe Feinglass ◽  
Samuel Wein ◽  
Caroline Teter ◽  
Christine Schaeffer ◽  
Angela Rogers
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Transitional Care ◽  
Behavioral Health Care ◽  
Care Quality ◽  
Care Staff ◽  
Internal Quality ◽  
Care Practice

This study is part of a mixed methods evaluation of a large urban medical center transitional care practice (NMG-TC). The NMG-TC provides integrated physical and behavioral health care for high need patients referred from the hospital emergency department or inpatient units and who lack a usual source of primary care. The study was designed for internal quality improvement and sought to evaluate staff perceptions of successful transitions for their medically and socially complex patients, and alternatively, the obstacles most likely to negatively impact patient outcomes. All 16 NMG-TC patient care staff were interviewed in a collaborative effort to produce empowered testimony that might go beyond expected clinical narratives. The interview schedule included questions on risk stratification, integrated mental health care, provider to provider handoffs, and how staff deal with key social determinates of patients’ health. The constant comparative method was used to deductively derive themes reflecting key domains of transitional care practice. Seven themes emerged: i) the need to quickly assess patient complexity; ii) emphasizing caring for major mental health and substance use issues; iii) obstacles to care for uninsured, often undocumented patients; iv) the intractability of homelessness; v) expertise in advancing patients’ health literacy, engagement and activation; vi) fragmented handoffs from hospital care and vii) to primary care in the community. Respondent stories emphasized methods of nurturing patients’ self-efficacy in a very challenging urban health environment. Findings will be used to conceptualize pragmatic, potentially high-impact transitional care quality improvement initiatives capable of better addressing frequent hospital use.

Dissemination, implementation, and quality improvement research within the HMO Cancer Research Network.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 215-215
Author(s):  
Brian S. Mittman ◽  
James W. Dearing ◽  
Kathleen Mazor ◽  
James Nutter ◽  
Keyword(s):  
Cancer Research ◽  
Quality Improvement ◽  
Cancer Care ◽  
Technical Assistance ◽  
Care Quality ◽  
Research Network ◽  
Dissemination And Implementation ◽  
Decision Makin ◽  
Cancer Research Network ◽  
Quality Improvement Research

215 Background: The HMO Cancer Research Network, funded by the National Cancer Institute, provides infrastructure support to facilitate cancer research in non-profit integrated healthcare delivery systems. A key CRN goal to improve quality and outcomes through research and research-based methods for accelerating implementation of innovations in cancer care. Methods: The CRN is led by a Steering Committee and an Executive Committee. CRN Scientific Working Groups support activity within distinct areas; the CRN Communication and Dissemination Scientific Working Group (C&D SWG) supports the design, conduct and reporting of research on (1) communication and decision makin in cancer care and (2) dissemination and implementation of cancer research findings and best practices. C&D SWG activities include monthly calls presenting C&D research resources, project ideas and funding opportunities; individual consultation and technical assistance to support CRN researchers developing funding applications and conducting research in relevant areas; and mentorship for CRN Scholars. General CRN resources to facilitate research to improve cancer care quality include a multi-institution Virtual Data Warehouse with accompanying query tools to facilitate preparatory-to-research and collaborative research studies and specific cancer-related data items; funding for Developmental and Pilot Studies; and an Outreach and External Collaborations Core to facilitate research collaborations among (a) CRN institution-based scientists, (b) scientists at other institutions, and (c) clinical and operations partners. Results: The CRN C&D SWG continues to stimulate increased awareness and interest in conducting dissemination and implementation studies and quality improvement research in cancer care, and to support the development of new project ideas and funding applications and the successful completion and publication of such studies. Conclusions: CRN activities facilitate innovative multi-site, multi-disciplinary cancer studies in the integrated delivery system setting, and motivate continued evolution of CRN institutions as the nation's premier learning health care systems. Supported by U24 CA171524.

scholarly journals Implementation of quality measures and patient-reported outcomes in an epilepsy clinic

Neurology ◽  
2019 ◽  
Vol 93 (22) ◽  
pp. e2032-e2041 ◽  
Author(s):  
Lidia M.V.R. Moura ◽  
Brandon Magliocco ◽  
John P. Ney ◽  
Eric M. Cheng ◽  
Gregory J. Esper ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Outcome Measurement ◽  
Quality Measures ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Measurement Information ◽  
Physical And Mental Health ◽  
Patient Reported ◽  
Systematic Collection

ObjectiveTo see if systematic collection of patient-reported epilepsy quality measures can identify opportunities to improve care, and to examine the associations between these measures and physical and mental health.MethodsWe developed a patient-reported questionnaire for medication adherence, seizure frequency, medication side effects, and driving that included the Patient-Reported Outcome Measurement Information System–10 (PROMIS-10) (physical and mental health). We offered it to all adult patients seen twice in an epilepsy clinic (January 2017–January 2018). The questionnaire was available on the web as well as a tablet provided at appointment check-in. We used the first completed questionnaire to explore the relationship between patient-reported care quality and measures of physical and mental health.ResultsA total of 610 unique patients (15% of the total encounters) completed a survey. Respondents were comparable to nonrespondents. Respondents reported gaps in care or opportunities for quality improvement in 48.4% (n = 295) of the encounters. Of patients who reported at least 1 seizure per month over the previous 3 months, 55.2% (n = 100) reported problems with adherence, 30.0% (n = 131) reported having problems believed to be adverse reactions to anticonvulsants, and 15.2% (n = 41) reported driving. In addition, respondents who reported either seizures over the recent 3 months, nonadherence to treatment due to cost, or anticonvulsant-associated adverse effects had consistently worse physical and mental health (all p < 0.05).ConclusionsSystematic collection of epilepsy quality measures endorsed by the American Academy of Neurology can identify opportunities for quality improvement. Measures of epilepsy care quality predict outcomes that matter to patients.

scholarly journals Aging With Autism Spectrum Disorder: An Exploration of Physical Activity Engagement

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 400-401
Author(s):  
Danielle Waldron ◽  
Beth Dugan ◽  
Jeffrey Stokes ◽  
Caitlin Coyle ◽  
John Kramer
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Autism Spectrum Disorder ◽  
General Population ◽  
Community Engagement ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Physical And Mental Health ◽  
Community Group ◽  
Factors Associated

Abstract Adults with Autism Spectrum Disorder (ASD) participate in physical activity (PA) infrequently compared to adults in the general population. This is problematic as individuals with ASD suffer from disproportionate physical and mental health co-morbidities as well as diminished life expectancy, but do not reap the physical and mental health benefits of PA. This study used data from the National Core Indicators-In Person Consumer Survey (n=4,370; age: 18-78) to analyze factors associated with both aerobic PA and muscle strengthening (MS) activity in adults with ASD receiving state Developmental Disability Services. This research used multilevel logistic regression modeling, with mediation and moderation analyses to explore personal and environmental factors associated with PA/MS in this population. Findings indicated the following significant associations between community engagement and PA and MS: community contact (OR=1.17; p&lt;0.001; OR=1.07; p&lt;0.001), community group participation (OR=1.83; p&lt;0.001; OR=1.91; p&lt;0.001), and employment/day program participation (OR=1.32; p&lt;0.05; OR=1.32; p&lt;0.001). Additionally, at older ages, participants were less likely to engage in PA and MS three or more times a week (OR=0.99; p&lt;0.05; OR=0.99; p&lt;0.05). These findings indicate that increasing age is associated with decreased PA and MS activity in this group, while community engagement may facilitate their PA and MS activity. While much remains unknown about the population aging with ASD, it is evident that they suffer from poorer health than the general population and have experienced lifelong difficulties with socialization and communication. Greater access to community engagement opportunities may promote this population’s healthy aging, as well as support their unique social needs.

scholarly journals Assessing organizational readiness for depression care quality improvement: relative commitment and implementation capability

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Lisa V Rubenstein ◽  
Marjorie S Danz ◽  
A Lauren Crain ◽  
Russell E Glasgow ◽  
Robin R Whitebird ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Quality ◽  
Organizational Readiness ◽  
Depression Care

scholarly journals A Community-Partnered, Participatory, Cluster-Randomized Study of Depression Care Quality Improvement: Three-Year Outcomes

2017 ◽  
Vol 68 (12) ◽  
pp. 1262-1270 ◽  
Author(s):  
Michael K. Ong ◽  
Loretta Jones ◽  
Wayne Aoki ◽  
Thomas R. Belin ◽  
Elizabeth Bromley ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Randomized Study ◽  
Care Quality ◽  
Depression Care ◽  
Cluster Randomized

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>

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