Application of an egocentric social network approach to examine changes in social connections following treatment for anxiety and depression: A novel measurement tool for clinical trials research?

The epidemic of loneliness and social isolation has been recognized as a public health crisis warranting the same prioritization as other public health issues today, such as obesity, substance use disorders, and tobacco use. Social disconnection is particularly prevalent and disabling among individuals with anxiety and depression, yet it is inadequately evaluated and addressed in most clinical psychology treatment research. Studies generally employ global measures of perceived connectedness, loneliness, or relationship satisfaction, limiting understanding about elements of one's social network that may change with treatment.

"Integrated behavioral health plus": The best of the worlds of collaborative care management, primary care behavioral health, and primary care.

Introduction: Discussions comparing the components and virtues of models of integrated behavioral health (IBH), that is, collaborative care management and primary care behavioral health, have been ongoing. In this conceptual article, we recommend shifting the focus to a broader set of components we have found essential to serve the needs of our patients, and hopefully the broader aims of dissemination and implementation of IBH.

Method: We detail our 20-year experience including the personnel, program components, challenges, successes, and plans for the future that will meet our patients' behavioral health needs and serve primary care.

A Cluster Randomized Trial of Primary Care Practice Redesign to Integrate Behavioral Health for Those Who Need It Most: Patients With Multiple Chronic Conditions.

Purpose: Patient outcomes can improve when primary care and behavioral health providers use a collaborative system of care, but integrating these services is difficult. We tested the effectiveness of a practice intervention for improving patient outcomes by enhancing integrated behavioral health (IBH) activities.

Methods: We conducted a pragmatic, cluster randomized controlled trial.

Amplification of Positivity Treatment for Anxiety and Depression: A Randomized Experimental Therapeutics Trial Targeting Social Reward Sensitivity to Enhance Social Connectedness.

Background: Social disconnection is common and causes significant impairment in anxiety and depressive disorders, and it does not respond sufficiently to available treatments. The positive valence system supports social bond formation and maintenance but is often hyporesponsive in people with anxiety or depression. We conducted an experimental therapeutics trial to test the hypothesis that targeting positive valence processes through cognitive and behavioral strategies would enhance responsivity to social rewards, a core mechanism underlying social connectedness.

Integrating behavioral health & primary care for multiple chronic diseases: Clinical trial of a practice redesign toolkit.

Context: Most patients in need of behavioral health (BH) care are seen in primary care, which often has difficulty responding. Some practices integrate behavioral health care (IBH), with medical and BH providers at the same location, working as a team. However, it is difficult to achieve high levels of integration.

COVID-19 vaccine hesitancy: Associations with gender, race, and source of health information.

Introduction: Vaccinations for COVID-19 are being distributed, yet vaccine hesitance is placing many people at risk for infection, negative outcomes, and compromising public health. Given primary care clinics are where people most often interact with health care providers, understanding factors associated with this hesitance may help providers in integrated primary care settings best address this hesitance.

Method: Between September and November of 2020, a survey was sent to all primary care patients within a large southern California health system, with over 10,000 responding (22% response rate).

Integrating Behavioral Health and Primary Care (IBH-PC) to improve patient-centered outcomes in adults with multiple chronic medical and behavioral health conditions: study protocol for a pragmatic cluster-randomized control trial.

Background: Chronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has difficulty responding.

Outpatient clinic visits during heat waves: findings from a large family medicine clinical database.

Introduction: The purpose of this study was to determine whether heat waves are associated with increased frequency of clinic visits for ICD-9 codes of illnesses traditionally associated with heat waves.

Methods: During 4 years of family medicine clinic data between 2012 and 2016, we identified six heat wave events in San Diego County. For each heat wave event, we selected a control period in the same season that was twice as long.

Translating patient self-management research into primary care: challenges and successes with group medical visits.

Essential to the implementation of a patient-centered medical home is use of evidence-based interventions by a well-coordinated team of providers in a cost-effective manner. Group Medical Visits (GMVs), designed to increase self-management behaviors in patients with chronic illness, have shown inconsistently to be efficacious. Despite the modest results reported thus far in the literature, GMVs have been promoted by the American Academy of Family Physicians as an important component in the patient-centered medical home.

Promoting self-management in diabetes: efficacy of a collaborative care approach.

Diabetes is a leading cause of death and is estimated to cost the United States 90 billion dollars annually. Increasing patient self-management skills has been shown to improve outcomes in patients with Type II diabetes. Promotion of shared decision-making between patient and provider is a core element of collaborative care and is especially well suited for increasing patient self-management.

Development and validation of a mental health subscale from the Quality of Well-Being Self-Administered.

Purpose: The purpose of this study was to create and validate a mental health subscale for the Quality of Well-Being Self-Administered (QWB-SA).

Methods: The QWB-SA and other measures such as the Profile of Mood States (POMS), Medical Outcomes Study 36 Item Short Form (SF-36), EuroQOL 5D (EQ-5D), and Health Utilities Index Mark 2 (HUI) were administered to three samples: a general population (N = 3,844), a non-psychiatric medical population (N = 535), and a psychiatric population (N = 915). Independent expert ratings of which items represented the construct of mental health were used along with psychometric methods to develop and validate a 10-item QWB-SA mental health scale.

Establishing the Collaborative Care Research Network (CCRN): a description of initial participating sites.

Collaborative care has increased dramatically in the past decade, yet the variability in collaborative strategies and the diversity of settings in which collaboration is being implemented make it difficult to assess quality and outcomes. Therefore, three aims were addressed in the current study: (a) describe and characterize the sites in the Collaborative Care Research Network (CCRN), (b) identify factors associated with practices' self-identified collaborative care model (e.g.

Primary care medical provider attitudes regarding mental health and behavioral medicine in integrated and non-integrated primary care practice settings.

Primary care medical providers (PCPs) have become de facto providers of services for the management of both mental and chronic illnesses. Although some reports suggest that PCPs favor having Behavioral Health colleagues provide behavioral health services in primary care, others demonstrate this view is necessarily not universal. We examined attitudes regarding behavioral health services among PCPs in practices that offer such services via onsite behavioral health providers (n = 31) and those that do not (n = 62).

If you build it, will they come? A qualitative evaluation of the use of video-based decision aids in primary care.

Background And Objectives: Given the growing presence of Patient-centered Medical Home practices and the need for patient participation, it is concerning that tools to improve patient participation are not widely used in primary care. Despite demonstrated effect on decision quality and patient satisfaction, decision aids (DAs) are not broadly utilized. We conducted focus groups to examine the use of DAs and uncovered barriers to greater DA utilization in primary care.

Are patients' initial experiences at the diagnosis of type 2 diabetes associated with attitudes and self-management over time?

Unlabelled: Objective The purpose of this study was to investigate patients' experiences when diagnosed with type 2 diabetes and diabetes-related distress and self-management years later. Method One hundred seventy-nine adults with type 2 diabetes, 1 to 5 years after diagnosis, completed a questionnaire assessing what they were told and what was recommended at diagnosis as well as current diet, physical activity, and diabetes distress.

Results: Most patients (60%) expressed confidence in their health care provider (HCP) at diagnosis, but 30% reported that a clear action plan was not communicated.

Laboratory evaluation to reduce respirable crystalline silica dust when cutting concrete roofing tiles using a masonry saw.

Respirable crystalline silica dust exposure in residential roofers is a recognized hazard resulting from cutting concrete roofing tiles. Roofers cutting tiles using masonry saws can be exposed to high concentrations of respirable dust. Silica exposures remain a serious threat for nearly two million U.

Assessment of family physicians' performance using patient charts: interrater reliability and concordance with chart-stimulated recall interview.

Peer-assessment processes with chart review have been used for many years to assess the clinical performance of physicians. The Quebec medical licensing authority has been required by provincial law to assess the practicing Quebec physicians on a nonvoluntary basis. During the period from January 2001 to November 2004, 25 family physicians in active practice were randomly selected from a pool of about 300.

Statistics and public health at CDC.

Since CDC's inception, an important function of the agency has been the compilation, analysis, and interpretation of statistical information to guide actions and policies to improve health. Sources of data include vital statistics records, medical records, personal interviews, telephone and mail surveys, physical examinations, and laboratory testing. Public health surveillance data have been used to characterize the magnitude and distribution of illness and injury; to track health trends; and to develop standard curves, such as growth charts.

Management of cluster headache.

Cluster headache, an excruciating, unilateral headache usually accompanied by conjunctival injection and lacrimation, can occur episodically or chronically, and can be difficult to treat. Existing effective treatments may be underused because of underdiagnosis of the syndrome. Oxygen and sumatriptan have been demonstrated to be effective in the acute treatment of cluster headaches.

Mental health treatment preferences of older and younger primary care patients.

Objective: To compare mental health treatment history and preferences in older and younger primary care patients.

Method: We surveyed 77 older (60+) and 312 younger adult primary care patients from four outpatient medical clinics about their mental health treatment history and preferences.

Results: Older adults were less likely than younger adults to report a history of mental health treatment (29% vs.

Comparison of measured utility scores and imputed scores from the SF-36 in patients with rheumatoid arthritis.

Purpose: We sought to evaluate 3 methods for imputing utility-based outcomes from clinical trial data measured using the Medical Outcomes Study 36-Item Short Form (SF-36).

Subjects: Our subjects included 131 male and 505 female adults (mean age, 55.42 +/- 12.

Validity of self-administered quality of well-being scale in musculoskeletal disease.

Objective: To evaluate the self-administered Quality of Well-Being (QWB-SA) Scale for patients with rheumatic diseases.

Methods: Family medicine patients (n = 562) and rheumatology patients (n = 334) were assessed using the following tools: QWB-SA, Health Assessment Questionnaire (HAQ), Arthritis Impact Measurement Scales (AIMS), and Rapid Assessment of Disease Activity in Rheumatology (RADAR).

Results: Patients with arthritis had significantly lower QWB-SA scores and significantly higher HAQ scores than family medicine patients with and without adjustment for covariates.

Use of the quality of well-being self-administered version (QWB-SA) in assessing health-related quality of life in depressed patients.

Background: This study evaluated the cross-sectional and longitudinal relationship between depression severity and the Quality of Well-Being scale self-administered version (QWB-SA) in subjects diagnosed with current major depression.

Methods: The research design was prospective and observational. Data were collected on a convenience sample of 58 subjects.

Gender differences in long-term posttraumatic stress disorder outcomes after major trauma: women are at higher risk of adverse outcomes than men.

Background: The importance of psychological morbidity after major trauma, such as posttraumatic stress disorder (PTSD), is continuing to gain attention in trauma outcomes research. The Trauma Recovery Project is a large prospective epidemiologic study designed to examine multiple outcomes after major trauma, including quality of life (QoL) and PTSD. Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge.