Effect of Family Navigation on Diagnostic Ascertainment Among Children at Risk for Autism: A Randomized Clinical Trial From DBPNet.

Importance: Early identification of autism spectrum disorder (ASD) is associated with improved cognitive and behavioral outcomes. Targeted strategies are needed to support equitable access to diagnostic services to ensure that children from low-income and racial/ethnic minority families receive the benefits of early ASD identification and treatment.

Objective: To test the efficacy of family navigation (FN), an individually tailored, culturally informed care management strategy, to increase the likelihood of achieving diagnostic ascertainment among young children at risk for ASD.

Developing a Problem-solving Intervention to Improve Self-Management and Transition Readiness in Adolescents with Sickle Cell Disease.

Purpose: Adolescents and young adults (AYA) with sickle cell disease (SCD) are at risk for serious complications including increased morbidity and early mortality during their transition from pediatric to adult care. Self-management support may help improve transition outcomes in this vulnerable population. Interventions based on teaching problem solving skills have been shown to improve adherence to therapy for AYA with other chronic disease and is a promising intervention in SCD.

Comparative Efficacy of Therapies for Treatment of Depression for Patients Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial.

Background: Although depression is common among patients receiving maintenance hemodialysis, data on their acceptance of treatment and on the comparative efficacy of various therapies are limited.

Objective: To determine the effect of an engagement interview on treatment acceptance (phase 1) and to compare the efficacy of cognitive behavioral therapy (CBT) versus sertraline (phase 2) for treating depression in patients receiving hemodialysis.

Design: Multicenter, parallel-group, open-label, randomized controlled trial.

Problem-Solving Education to Prevent Depression Among Low-Income Mothers: A Path Mediation Analysis in a Randomized Clinical Trial.

Importance: Although problem solving has been an important component of successful depression prevention and treatment interventions, evidence to support problem solving's mechanism of action is sparse.

Objective: To understand the mechanism of an efficacious depression prevention intervention, problem-solving education (PSE).

Design, Setting, And Participants: A multivariate path analysis was embedded within a randomized efficacy trial (February 15, 2011, to May 9, 2016).

Engaging Mothers With Depressive Symptoms in Care: Results of a Randomized Controlled Trial in Head Start.

Objective: The authors sought to determine whether a multicomponent, community-based program for preventing maternal depression also promotes engagement with mental health services for individuals with persistent symptoms.

Methods: Mothers of children enrolled in Head Start were randomly assigned between February 2011 and May 2016 to Problem-Solving Education (PSE) (N=111) or usual services (N=119) and assessed every two months for 12 months.

Results: Among 230 participants, 66% were Hispanic; 223 participants were included in the analysis.

Efficacy of a Maternal Depression Prevention Strategy in Head Start: A Randomized Clinical Trial.

Importance: Low-income and minority mothers experience a disproportionate incidence of depression and lack access to treatment services. Development of prevention strategies in accessible community-based venues is a potentially important public health strategy.

Objective: To determine the efficacy of a depression prevention strategy embedded in Head Start.

Harnessing the Capacity of Head Start to Engage Mothers with Depression in Treatment.

We assessed dimensions of feasibility of a patient navigation system in the Head Start preschool setting to help low-income mothers with depression engage with mental health care. Forty-seven mothers participated; none refused. Navigators demonstrated excellent model fidelity; we experienced no adverse events.

Patient Navigation for Mothers with Depression who Have Children in Head Start: A Pilot Study.

This study assesses the potential of social work-facilitated patient navigation to help mothers with depression engage with mental health care. We conducted a randomized pilot trial (N = 47) in Head Start-a U.S.

Reducing Disparities in Timely Autism Diagnosis Through Family Navigation: Results From a Randomized Pilot Trial.

Objective: Emerging evidence suggests that autism spectrum disorder (ASD) can be diagnosed by age 18 months and that early intensive behavioral intervention positively affects ASD core deficits. This pilot randomized controlled trial examined the feasibility of using an adapted form of patient navigation, Family Navigation (FN), to improve timely diagnosis of ASD in low-income families from racial-ethnic minority groups.

Methods: Forty children referred for an ASD diagnostic assessment were randomly allocated to receive FN or usual care.

Rationale and design of A Trial of Sertraline vs. Cognitive Behavioral Therapy for End-stage Renal Disease Patients with Depression (ASCEND).

Major Depressive Disorder (MDD) is highly prevalent in patients with End Stage Renal Disease (ESRD) treated with maintenance hemodialysis (HD). Despite the high prevalence and robust data demonstrating an independent association between depression and poor clinical and patient-reported outcomes, MDD is under-treated when identified in such patients. This may in part be due to the paucity of evidence confirming the safety and efficacy of treatments for depression in this population.

Avoidance as an obstacle to preventing depression among urban women at high risk for violent trauma.

The impact of depression interventions is often attenuated in women who have experienced trauma. We explored whether psychological avoidance could explain this phenomenon. We synthesized two pilot randomized trials of problem-solving education (PSE) among a total of 93 urban mothers.

A qualitative study of parenting stress, coping, and discipline approaches among low-income traumatized mothers.

Objective: The use of harsh discipline is a risk factor for child maltreatment and is more common among families in which mothers have previously experienced trauma. We sought to understand the stressors experienced by low-income traumatized mothers and the perceived impact of those stressors on their discipline approaches.

Methods: We conducted 30 in-depth qualitative interviews with low-income mothers with a history of trauma.

The role of sociocultural information in mental health intake sessions.

Background: Clinicians are advised to provide culturally competent care but little is known about how this directive translates into clinical practice. we investigated how this directive was implemented by describing how clinicians utilize sociocultural (SC) information, and how it impacts the clinical encounter.

Method: Data were collected in clinics in the Northeast of the U.

Adaptation of problem-solving treatment for prevention of depression among low-income, culturally diverse mothers.

Adapting evidence-based interventions to be more accessible and culturally sensitive to the needs of diverse populations is a potential strategy to address disparities in mental health care. We adapted an evidence-based depression-treatment strategy, Problem-Solving Treatment, to prevent depression among low-income mothers with vulnerable children. Intervention adaptations spanned 3 domains: (1) the intervention's new prevention focus, (2) conducting a parent-focused intervention in venues oriented to children; and (3) cultural competency.

"Just be straight with me:" an exploration of Black patient experiences in initial mental health encounters.

It is advantageous for a clinician to understand how patients feel about their initial encounters, but it can be difficult to discern what is and what is not working. This qualitative, exploratory study is guided by the question, "What happens during an initial mental health encounter between a Black patient and a non-Black provider that leads the patient to describe it as a good or poor experience?" The findings are based on face-to-face, postintake interviews with 14 Black patients seen by 11 non-Black providers as part of the Patient-Provider Encounter Study. The objective is to explore the initial interpersonal interactions between Black patients and their non-Black mental health providers and to better understand how patients come to describe the encounter as good (favorable) or poor (unfavorable).

Potential impact of trauma on the ability to prevent depression among low-income mothers.

Background: Violent trauma is common in urban communities. We explored the hypothesis that past trauma could moderate the effect of a cognitive behavioral intervention designed to prevent depression among urban, low-income mothers.

Methods: Synthesis of two pilot randomized trials of problem solving education (PSE) among 93 mothers of children hospitalized in the neonatal intensive care unit or enrolled in community-based Early Intervention programs.

Preferences for relational style with mental health clinicians: a qualitative comparison of African American, Latino and Non-Latino White patients.

The goal of this study is to analyze preferences for relational styles in encounters with mental health providers across racial and ethnic groups. Four primary themes describe what patients want from a mental health provider: listening, understanding, spending time, and managing differences. However, using contextual comparative analysis, the findings explicate how these themes are described differently across African Americans, Latinos, and non-Latino Whites, uncovering important qualitative differences in the meaning of these themes across the groups.