Fam Syst Health
December 2024
The editors feel so much gratitude for the opportunity that they had to witness, create, and develop published science. They absolutely loved working with hundreds of authors and seeing the fruition of their work, which they hope will be applied at the Point of Care delivery in practice settings for real-world impact. The editors feel indebted to so many partners in this work (see the Acknowledgments section).
View Article and Find Full Text PDFBackground: Anxiety is highly prevalent, but undertreated, in primary care. Brief, non-pharmacological interventions are needed. Modular Anxiety Skills Training (MAST), a cognitive-behavioral anxiety intervention, was developed for primary care and tailored for a Veteran sample (MAST-V).
View Article and Find Full Text PDF: Brief alcohol interventions (BAIs) are an evidence-based practice for addressing hazardous alcohol use in primary care settings. However, numerous barriers to implementation of BAIs in routine practice have been identified, including concerns about patient receptivity to BAIs. Despite this being a commonly identified barrier to BAI implementation, little BAI implementation research has focused on patient receptivity.
View Article and Find Full Text PDFFam Syst Health
September 2023
The perceived disconnect between research and clinic contexts may thus result in frontline clinicians and administrators questioning the approachability and applicability of science to their day-to-day work with patients and families in integrated care. Science grinds along so painstakingly slowly that even within the research community, some thought leaders have called for a moratorium on RCTs in favor of approaches that will yield more immediate public health impact (Kessler & Glasgow, 2011). The aim of this editorial is to describe a both/and research approach called "hybrid studies" and to discuss achievable strategies for doing this kind of work on the front lines.
View Article and Find Full Text PDFIn this editorial, the authors explain the function and process of peer review, challenges they experienced in the wake of the COVID-19 pandemic, and strategies for ensuring that this fundamental process continues with integrity. In conclusion, the efforts of this editorial team to maintain a robust reviewer pool by inspiring, rewarding, training, and growing diversity cannot be the only efforts in this area. Those who "decline" jury duty may experience punitive consequences; however, there are no direct consequences for a qualified professional who declines to review, even routinely.
View Article and Find Full Text PDFThis study explores differences in characteristics and relationship treatment preferences across different levels of intimate partner violence (IPV) among Veterans Affairs (VA) primary care patients. In Fall 2019, we sent a mail-in survey assessing relationship healthcare needs to N = 299 Veterans randomly sampled from 20 northeastern VA primary care clinics (oversampling female and younger Veterans). We compared those reporting past year use or experience of physical/sexual aggression, threats/coercion, or injury (Severe IPV; 21%), to those only reporting yelling and screaming (Verbal Conflict; 51%), and denying any IPV (No IPV; 28%).
View Article and Find Full Text PDFCognitive-behavioral treatment for anxiety disorders and symptoms remains underutilized in integrated primary care (IPC), in part because the many treatments developed for specialty care are not readily translated to this unique setting. The objective of this study was to identify barriers and facilitators to behavioral health providers (BHPs) delivering evidence-based cognitive--behavioral anxiety interventions within IPC practice. We conducted semistructured interviews with a national sample of 18 BHPs (50% psychologists, 33% social workers, 17% registered nurses) working in IPC in the Veterans Health Administration.
View Article and Find Full Text PDF: To examine whether sexual assault prospectively predicts unhealthy weight management behaviors in college women. : Participants were female college students ( = 483) with monthly assessments across the first year, including the frequency and severity of sexual assault and unhealthy weight management behaviors. : Frequency of sexual assault prior to college predicted dieting, purging, and diet pill use, over the first year.
View Article and Find Full Text PDFFam Syst Health
June 2022
Our annual coeditors' retreat is a time to step back from the words on the page and reflect on our values for this work. Our values set the course for goals and subsequent actions for the year. In our 3 days away from the office to focus on the journal, we have the quiet space to set intentions.
View Article and Find Full Text PDFIn 2013, a bunch of us ran around collecting paper surveys off chairs after a plenary address at the Collaborative Family Healthcare Association's (CFHA) annual conference. From 150 responses, we found that less than a quarter would take the time to attend a workshop about research and evaluation. Fast forward 5 years: The organization showed robust attendance at research and evaluation training sessions, and interest in a preconference had risen to 77%.
View Article and Find Full Text PDFAnxiety is undertreated in primary care, and most treatment provided is pharmacological rather than behavioral. Integrating behavioral health providers (BHPs) using the Primary Care Behavioral Health (PCBH) model can help address this treatment gap, but brief interventions suitable for use in PCBH practice are needed. We developed a modular, cognitive-behavioral anxiety intervention, Modular Anxiety Skills Training (MAST), that is evidence-based, transdiagnostic, feasible for PCBH, and patient-centered.
View Article and Find Full Text PDFPrimary care (PC) settings increasingly use team-based care activities with embedded behavioral health providers (BHPs) to enhance patient care via group medical visits, conjoint appointments, team huddles, and warm handoffs. Aim 1 was to describe the variation of team-based care activities within integrated PC clinics. Aim 2 was to explore whether factors associated with the BHP (e.
View Article and Find Full Text PDFIntroduction: Integrated primary care teams are increasingly relying upon virtual care, including both telehealth and team members who are teleworking, due to the COVID-19 pandemic. This shift to virtual care can present challenges for the coordination and provision of team-based care in primary care. The current report uses extant literature on teams to provide recommendations to support integrated primary care teams, including behavioral health providers, in adapting to and sustaining virtual team-based care.
View Article and Find Full Text PDFEven with the expansion of primary care teams to include behavioral health and other providers from a range of disciplines, providers are regularly challenged to deliver care that adequately addresses the complex array of biopsychosocial factors underlying the patient's presenting concern. The limits of expertise, the ever-changing shifts in evidence-based practices, and the difficulties of interprofessional teamwork contribute to the challenge. In this article, we discuss the opportunity to leverage the interprofessional team-based care activities within integrated primary care settings as interactive educational opportunities to build competencies in biopsychosocial care among primary care team members.
View Article and Find Full Text PDFIntroduction: Anxiety symptoms are common, yet undertreated, among primary care patients. Accommodating patient treatment preferences improves engagement and retention. In contrast to depression, little is known about primary care patients' preferences for anxiety treatment.
View Article and Find Full Text PDFBackground: Sexual health is an important, yet often overlooked, aspect of overall health. Veterans may be particularly at risk for sexual dysfunction. The objectives of this study were to assess the prevalence and correlates of sexual dysfunction and examine preferences among veterans for discussing sexual problems.
View Article and Find Full Text PDFSelf-Monitoring (SM), the act of observing ones' own behavior, has been used in substance use treatment because SM may bring conscious awareness to automatized substance use behaviors. Empirical findings regarding SM's effectiveness are mixed. The aim of this study was to synthesize the literature for the efficacy of SM on substance use.
View Article and Find Full Text PDFBackground: Behavioral activation is ideal for embedded behavioral health providers (BHPs) working in primary care settings treating patients reporting a range of depressive symptoms. The current study tested whether a brief version of Behavioral Activation (two 30-minute appointments, 2 boosters) designed for primary care (BA-PC) was more effective than primary care behavioral health treatment-as-usual (TAU) in reducing depressive symptoms and improving quality of life and functioning.
Methods: Parallel-arm, multi-site randomized controlled trial.
Introduction: Prevalence rates of anxiety disorders and symptoms in primary care (PC) settings are very high. Behavioral health consultants in primary care behavioral health (PCBH) settings enable increased access to evidence-based anxiety treatment. Despite strong extant support for exposure-based therapy for anxiety disorders, the use of exposure to treat anxiety in PC settings is low.
View Article and Find Full Text PDFIntroduction: Although anxiety is highly prevalent in primary care and a top reason for referral to primary care behavioral health (PCBH) services, there are limited data on which anxiety interventions are used in routine PCBH practice. The objective of this study was to identify interventions delivered when treating anxiety in PCBH practice.
Method: We conducted an online survey of PCBH providers regarding their clinical practice with patients who present for treatment of anxiety symptoms.
Researchers have argued there are bidirectional associations between heavy alcohol use and sexual assault; however, research in this area is inconclusive due to methodological differences, particularly in study design. The purpose of this study is to clarify the longitudinal associations between heavy alcohol use and incapacitated sexual assault among first-year college women, accounting for hypothesized autoregressive effects within each construct over their first year of college. A sample of 483 women completed regular surveys that assessed a range of health behaviors, including alcohol use and sexual behavior, during their first year of college.
View Article and Find Full Text PDFDepressive symptoms are the most common reason for referral to integrated behavioral health providers in primary care. Although evidence-based brief psychotherapies for depression in primary care exist, treatment duration is a significant barrier to implementation. In this open trial, we examined the patient experience of receiving a brief behavioral activation intervention designed for use in primary care (BA-PC), which comprised 2 30-min appointments and 2 boosters spaced 2-3 weeks apart across 12 weeks, and its impact on depression symptoms.
View Article and Find Full Text PDFA precollege history of sexual victimization predicts revictimization during college, making it important to understand the mechanisms underlying the victimization-to-revictimization pathway. The study aimed to test whether heavy episodic drinking and personal and peer hookup norms mediate revictimization for two types of unwanted sexual contact: sexual coercion (attempted and/or completed sexual assault by the use of verbal coercion) and sexual assault (attempted and/or completed sexual assault by the use of force, threats, or incapacitation). At college entry, 483 first-year college women completed self-report measures of their precollege experiences, including history of sexual victimization and health behaviors (i.
View Article and Find Full Text PDFSexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women.
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