Finding purpose.
The murder of George Floyd served as a catalyst to activate national outrage for the deaths of the many who preceded him, in the midst of the COVID-19 pandemic, has brought to light racial health disparities evident in our country and in our communities. While previous President’s columns have included a call to action to engage with and improve the health care system, the glaring health inequities associated with COVID-19 and the Black Lives Matter movement implores deeper reflection. The author questions his role in maintaining the status quo, acknowledging health care disparities as a white male physician, and ack...
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Healing words: My journey with poetry and medicine.
In this essay, I reflect on the origins of my relationship to writing, as well as my journey with poetry and medicine as a health psychologist, medical educator, medical/health humanities scholar, and poet. I explore how these two seemingly disparate disciplines became entwined in my life and how I came to understand poetry as a kind of healing art. The essay concludes with gratitude for the opportunity to have mentored other writers, poets, and students on their paths to more deeply comprehend and honor our shared humanity. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

“Storytelling as a vehicle of healing”: Johanna Shapiro, PhD, professor, psychologist, poet, medical humanities scholar.
This commentary reflects the professional life story of a respected editor, poet, and champion of medical humanities, Johanna Shapiro. A psychologist by training, Johanna’s work in medical humanities is well known and respected by health professionals in multiple venues. It is within family medicine that Johanna found her professional home. Her work has focused on the value of storytelling as a vehicle of healing, helping health professionals at all levels of training better understand their patients’ experiences of illness and healing. The understanding helps patients more deeply connect to their illness and w...
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Hope.
This poem focuses on a mother's love and pregnancy. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Ode to self-care.
This poem focuses on the importance of self-care as a therapist. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Colorado’s continuing journey to integrated care: Progress!
This commentary discusses the journey to integrated behavioral health and primary care in the state of Colorado. The authors discuss integrated care, and the lessons learned by early adopters can help those just getting started. They argue integration is possible in practice settings of all types despite the barriers that exist - but these barriers must continue to be broken down for further scaling and long-term sustainability. While adequate payment, workforce, and data-sharing infrastructure and policy are necessary for scaling and sustainability, they are not sufficient: practice transformation support is crucial for a...
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Patient experience with a large-scale integrated behavioral health and primary care initiative: A qualitative study.
This study highlights the importance of seeking outpatient feedback and incorporating these experiences into the redesign of integrated care systems. Formal mechanisms, such as patient advisory boards, are needed to ensure that health care quality improvement initiatives are patient centered. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Clinician’s corner: Response to Gormley et al.
This study demonstrates the importance of sustained measurement over time; however, regularly conducting direct observations is a large use of resources and not feasible for most clinicians. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

The relationship between integrated pediatric psychology and primary care visit length, revenue, content over 24 months.
This study shows that initial efficiencies or improvements (e.g., time, cost, content) associated with integrating BH may be lost over time. Future studies should evaluate sustainability in relation to program impact. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

“No one could calm him down”: Mothers’ experience of autism diagnosis and obtainment of resources in an urban public school district.
Discussion: The mothers’ narratives indicated a strong need for advocacy and parent–school partnership. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Intercultural differences in healthcare experiences of Latinos in a nontraditional destination area.
Discussion: Mexicans and Guatemalans show different patterns of health care engagement and express distinct concerns. Future work should consider the role of health literacy in informing the heterogenous experiences and needs of Latinos from diverse countries of origin. Further, interventions should train health care providers to provide culturally sensitive services, with interpreters available in multiple languages to address heterogenous language needs. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Implementation science on the margins: How do we demonstrate the value of implementation strategies?
Implementation science (IS) has developed as a field to assess effective ways to implement and disseminate evidence-based practices. Although the size and rigor of the field has improved, the economic evaluation of implementation strategies has lagged behind other areas of IS (Roberts, Healey, & Sevdalis, 2019). Beyond demonstrating the effectiveness of implementation strategies, there needs to be evidence that investments in these strategies are efficient or financially sustainable. In this editorial, we lay out conceptual challenges in applying economic evaluation to IS and the implications for conducting economic an...
Source: Families, Systems, and Health - September 21, 2020 Category: International Medicine & Public Health Source Type: research

Engagement interventions delivered in primary care to improve off-site pediatric mental health service initiation: A systematic review.
Discussion: Currently, there is limited evidence for engagement interventions to improve the referral-to-service gap for children and families. More research is needed to develop and evaluate effective mental health engagement interventions, particularly for disadvantaged youth and families. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - July 23, 2020 Category: International Medicine & Public Health Source Type: research

Rural clinics implementing collaborative care for low-income patients can achieve comparable or better depression outcomes.
This study evaluates depression treatment outcomes, clinical processes of care, and primary care provider experiences for CoCM implementation in 8 rural clinics treating low-income patients. Method: We used CoCM registry data to analyze depression response and remission then used logistic regression to model variance in depression outcomes. Primary care providers reported their experiences with this practice change 18 months following program launch. Results: Participating clinics enrolled 5,187 adult patients, approximately 15% of the adult patient population. Mean PHQ-9 depression score was 16.1 at baseline and 10.9 at l...
Source: Families, Systems, and Health - July 23, 2020 Category: International Medicine & Public Health Source Type: research

Are marital relationships a barrier to health care utilization in Southern Appalachia?: A dyadic examination of the link between marital quality and individual health care usage.
Introduction: There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian. Method: Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplu...
Source: Families, Systems, and Health - June 25, 2020 Category: International Medicine & Public Health Source Type: research

COVID-19: Complexity and the Black Swan.
In previous President’s Columns (Valeras, 2019a, 2019b), the properties of complexity and complex adaptive systems have been discussed, in terms of the value of continual and iterative change, in order to nudge a system to emerge differently, rather than maintain the status quo. COVID-19 is not a nudge; it is a tidal wave. Engaging with and understanding complexity science allows us to examine the internal rules of our health care system and recognize our own role as agents that can systematically and deliberately disrupt the status quo. The intertwined and interdependent complex relationships that exist in health ca...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Tigress in a cage.
This poem is about an elderly client trapped in an abusive relationship. The client has a history of complex trauma and suffers from major depression. During the course of our sessions, she started cutting herself. As her psychotherapist, I was concerned that she may be regressing. I struggled to appreciate the reason for her self-mutilation and redirected her attention from the past to the present. As we processed her trauma, this poem was my attempt to help her gain insight into her cutting behavior and her triggers regarding the opposite sex. My goal was for the client to practice dual awareness and envision a future in...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

“Marlboro madrigal”.
Presents a poem about a hospitalized patient who continues to smoke cigarettes. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Nights with sickle cell.
The majority of sickle cell disease (SCD) patients suffer from numerous health problems like chronic pain and anemia. Oftentimes these patients require emergency health care, including unscheduled blood transfusions to treat or prevent severe complications accompanied with SCD. This poem explores a Black SCD patient’s experiences with implicit and explicit biases among health care providers as a person with this type of condition seeks emergency care. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Thanking you while fading away.
Presents a poem that is written from the perspective of a dying patient who is thanking the medical team that attempts to resuscitate them. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Student doctor.
Presents a poem about a student doctor who gets a haircut from a patient with beauty school aspirations while in a drug rehab unit. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Coming full circle (to hard questions): Patient- and family-centered care in the hospital context.
Roughly 60 years after the first questions were raised about hospitalized patients, Kaslow and colleagues (see record 2020-40858-010) articulate the importance of patient- and family-centered care and outline recommendations for hospitalist care teams. They concisely point out the need for such practices, but more important, they provide many practical examples. Some of the main recommendations include (a) form partnerships, (b) prioritize communication, (c) discuss care goals, (d) share decision-making, (e) collaborate to implement the treatment plan, (f) negotiate differences, and (g) make special accommodations for disc...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Collaborative patient- and family-centered care for hospitalized individuals: Best practices for hospitalist care teams.
This article offers principles and associated strategies to reduce those barriers and guide implementation of systemically informed, collaborative, and culturally responsive patient- and family-centered care provided by hospitalist care teams, especially regarding collaborative decision-making for treatment and discharge planning. Such an approach is associated with reduced lengths of stay and hospital costs and lowered rates of medical errors and mortality. It also is linked to improved patient and family cooperation and adherence; enhanced quality of care and clinical outcomes; and increased levels of satisfaction among ...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Anxiety interventions delivered in primary care behavioral health routine clinical 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. The final sample comprised 209 PCBH providers recruited from e-mail listservs of national professional organizations (59.3% psychologists, 23.4% social workers, 12.4% counselors, 4.8% other). Providers reported on use (yes/no) of 17 interventions in their most recent session with their most recent adult patient presenting with a primary concern of non-trauma-related an...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Coaching patients to be active, informed partners in their health.
In this issue, the article “A Physician Communication Coaching Program,” by McDaniel and colleagues (see record 2020-40858-007), addresses this untenable situation through the coaching of physicians as part of continuing medical education. The coaching program hopes to explode the traditional paradigm of physician–patient interaction. An alternative paradigm is the philosophy of health coaching. While McDaniel et al. (2020) describe coaching physicians, the new paradigm involves coaching patients. Health coaching can be summed up in the adage: “Give a man a fish and you feed him for a day. Teach him...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

A physician communication coaching program: Developing a supportive culture of feedback to sustain and reinvigorate faculty physicians.
Discussion: Based on physician endorsement, experienced coaches are expanding the coaching program to physicians throughout our institution. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Assessment and management of depression and suicidality: Pediatric resident perspectives on training and practice.
Conclusions: Recommendations for pediatric residency program training processes are discussed, including the potential added value of colocating mental health clinicians into the primary care continuity training clinic. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Family functioning, coparenting, and parents’ ability to manage conflict in adolescent anorexia nervosa subtypes.
Discussion: These findings underline the importance of increasing knowledge on specific aspects of general family functioning. In particular, it seems that the way parents manage conflict between themselves as partners can have a role in the maintenance of AN. Clinical implications of these results are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Reflections in the mirror: Bias, stereotypes and professional responsibility.
In this issue, Flynn and colleagues (see record 2020-40858-002) have authored an important article on the positive role for behavioral health integration in improving health, mental health, and quality of life for Latinx primary care patients along the U.S.-Mexico border (Flynn, Gonzalez, Mata, Salinas, & Atkins, 2020). The title of the article is “Integrated Care Improves Mental Health in a Medically Underserved US-Mexico Border Population.” Article titles, of course, never tell the full story contained within. The author’s use of the term medically underserved as a descriptor invites reflection on o...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Barriers and mechanisms of change: The impact of trauma and relationships.
In their article “Integrated Care Improves Mental Health in a Medically Underserved U.S. Mexico Border Population,” Flynn, Gonzalez, Mata, Salinas, and Atkins (see record 2020-40858-002) report on an integrated care model using promotoras to address diabetes in a Latino population. Overall, they found that participants had improved quality of life (QoL) and depression measures; however, physical health outcomes did not improve significantly compared to the comparison group. In this commentary, we draw on our expertise working with the Latino population in mental health settings, most recently with refugees at t...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

Integrated care improves mental health in a medically underserved U.S.-Mexico border population.
This study evaluated the effect of an integrated behavioral health care model, including promotoras(es), on a primarily Hispanic population living with diabetes. Method: Seven hundred fifty-six participants were enrolled in an intervention (n = 329) or comparison group (n = 427) and followed up for 12 months. We used a quasiexperimental design to compare participants who received coordinated integrated behavioral health care with those who received usual care from a federally qualified health center. The outcomes were HbA1c, blood pressure, body mass index, depressive symptoms (Patient Health Questionnaire-9), and quality ...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

A walk on the translational science bridge with leaders in integrated care: Where do we need to build?
Entrepreneurs in integrated care face some of the same challenges in empirically demonstrating impact, regardless of the model of care they espouse. In this editorial, 2 leading model developers reflect on the state of the science in primary care integration, including research gaps and promising research underway. We asked these leaders to discuss conceptual areas of shared concern, and we present those with reference to the metaphor of the translational research bridge. Their insights resonate with one another and suggest a role for collaboration to advance empirical support for the implementation of integrated care. (Ps...
Source: Families, Systems, and Health - June 11, 2020 Category: International Medicine & Public Health Source Type: research

The parable of the wolf.
The article presents a parable relating to soldier's combat experiences in Afghanistan. The parable itself derives from the children's story The Three Little Pigs and the Big Bad Wolf. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - April 16, 2020 Category: International Medicine & Public Health Source Type: research

Development and initial validation of a measure of parents’ preferences for behavioral counseling in primary care.
Discussion: The BIPS holds potential for informing the design and dissemination of primary care parenting interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - April 16, 2020 Category: International Medicine & Public Health Source Type: research

Parent-perceived barriers to child weight management: Measure validation in a clinical sample.
Introduction: Although families face many barriers to obtaining and maintaining a healthy weight status for children, there remains a lack of psychometrically sound tools to assess perceived barriers. The Barriers to Child Weight Management (BCWM) scale quantitatively assesses parents’ perceptions of barriers to engaging in positive weight-related behaviors but has not been validated within a clinical sample. The present study sought to validate the BCWM scale among parents of children presenting to a tertiary pediatric weight management clinic. Method: Participants included 258 parents of children aged 6–18 ye...
Source: Families, Systems, and Health - April 16, 2020 Category: International Medicine & Public Health Source Type: research

Psychometric properties of the Portuguese adaptation of General Functioning of Family Assessment Device: A comparative study.
This study analyzed the psychometric properties of the General Family Functioning subscale in Portuguese families with adolescents diagnosed with Type I Diabetes and healthy adolescents comparing also family functioning in both samples. Method: A total of 100 parents of adolescents with Type I Diabetes and 106 parents of healthy adolescents participated in this study. A confirmatory factor analysis was performed for both samples to analyze the adequacy of each model. Results: Both confirmatory factor analyses maintained the design in one-factor models with good fit indexes. The internal consistency in both samples was good...
Source: Families, Systems, and Health - April 13, 2020 Category: International Medicine & Public Health Source Type: research

Effects of a family diabetes self-management education intervention on the patients’ supporters.
Discussion: Future research on family DSME should consider ways to improve family member attendance; have them set their own health improvement goals; and integrate healthy lifestyle education, such as healthy eating and being physically active, along with the DSME core content to create an added benefit of diabetes prevention for participating family members. The limitations of this study and recommendations for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - April 13, 2020 Category: International Medicine & Public Health Source Type: research

Healthcare’s wicked questions: A complexity approach.
The previous President’s Column explored Glouberman and Zimmerman’s (2002) differentiation of complex problems versus those that fall under the domains of simple or complicated, concluding with an invitation to enter the fray for health care’s future state (Valeras, 2019). In this second column on the subject of complexity, the author invites us to continue to explore the topic of complexity and embrace it within health care, rather than shy away from it, in order influence the future state. One tactic, when engaging with a complex adaptive system, is to ask Wicked Questions. Williamson (2015) defines Wic...
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

My first client: The lioness.
This poem is about a mother who suffered from borderline personality disorder and schizophrenia. The mother recently lost custody of her daughter due to her physical abuse of the child. Both were ordered by the court to attend therapy sessions to improve their attachment. As a family therapist, I struggled to keep a balance between empathizing with, and challenging the mother. I wrote this poem and used it in session to help the mother appreciate the effect of her aggressive behaviors on her daughter. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

Encounter.
In this poem, a palliative care provider describes an encounter with a patient. She answers simple heavy questions from a patient about who she is, what she does, what she knows, and what she has. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

Patient in recovery.
This 55-word story, written by a licensed independent clinical social worker, briefly describes a female patient in recovery from abuse by her grandfather. The patient used drugs to mask the pain. Today she is clean. An aunt revealed that she was guilty of betraying the child in this case of incest. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

The first year.
Poetry representing research data can be a powerful tool to further empathy and understanding of participants’ stories (Furman, Lietz, & Langer, 2006). This poem represents a semi-structured interview, with portions transcribed to embody utterances, tone, and phrasing in the poem’s form. The transcription has been rearranged to produce a holistic and focused story. A combination of Poindexter’s (2002) and Gee’s (1991) linguistic approaches and work inspired the construction of this poem. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

Who is driving change, and where is it taking us? Interview with an expert.
This article reflects a recent wide-ranging conversation with Linda Rosenberg, the president and CEO of NCBH. Trained as a social worker, Rosenberg was senior deputy commissioner of the New York State Office of Mental Health prior to joining the NCBH and is a dynamic and high-energy strategist and thought leader in the field of community mental health and integrated care. We discussed issues impacting payment for integrated care, including private equity investment, capitated payment, and the role of risk, and how these market dynamics impact vulnerable populations. For the sake of brevity, we summarize our conversation wi...
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

Patterns of coping among caregivers of children with spinal cord injury: Associations with parent and child well-being.
Introduction: Few studies have investigated how caregivers manage stressors associated with their child’s spinal cord injury (SCI) and how these patterns relate to their child’s coping and adjustment. The current study explored empirically derived coping profiles among caregivers of youth with SCI and the relation of these patterns to parent and youth psychosocial outcomes. Method: This was a cross-sectional survey of 318 children (ages 1 to 18) and a primary caregiver. Participants completed measures assessing demographics, coping, quality of life (QOL), anxiety, and depression. We utilized hierarchical and no...
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

A recipe for assessing fidelity in family and health systems.
Following recipes is an analogy for maintaining intervention integrity, or, fidelity. Fidelity is the extent to which an intervention is implemented as intended. This editorial presents a recipe for assessing fidelity in family and health systems. The author discusses the challenges posed by the complex recipes of families and health systems interventions, in both research and clinical practice. The author concludes that increasing the measurement and reporting of fidelity is paramount in the exploding literature around family and health systems research. Researchers and practice improvement champions must find ways to ass...
Source: Families, Systems, and Health - June 10, 2019 Category: International Medicine & Public Health Source Type: research

Through the woods.
Many individuals find themselves taking care of a family member or loved one with a terminal illness. This narrative illustrates how my family and I navigated this caretaking process as a system and how this experience shaped my family-centered approach to care in medical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - May 6, 2019 Category: International Medicine & Public Health Source Type: research

Relationship between parent mood and resilience and child health outcomes in pediatric asthma.
This study explored the relationship between parent and child psychosocial functioning and asthma-related health outcomes in a sample of at-risk children with asthma. We hypothesized that greater parent resilience would be associated with better parent mood, more symptom-free days (SFDs), better child mood, and less child anxiety. Further, we hypothesized that parent resilience would moderate the relationship between parent mood and SFDs. Method: We performed a secondary analysis of baseline cross-sectional enrollment data. Parents of African American children on Medicaid with persistent asthma reported their children&rsqu...
Source: Families, Systems, and Health - May 6, 2019 Category: International Medicine & Public Health Source Type: research

The impact of behavioral health consultations on medical encounter duration in pediatric primary care: A retrospective match-controlled study.
We examined the impact of embedded BHCs on duration of medical encounters in a pediatric primary care clinic. Method: We conducted a retrospective matched-pairs analysis of encounters involving behavioral consultations versus encounters for similar patients that did not include a consultation (N = 114) using electronic health record timestamp data. We examined both medical duration (i.e., medical provider services) and total duration (i.e., medical services + behavioral consultation). Results: Patient encounters involving behavioral consultation had a significantly longer (+11.23 min) total duration than matched controls, ...
Source: Families, Systems, and Health - May 6, 2019 Category: International Medicine & Public Health Source Type: research

Prevalence and characteristics of universal depression screening in U.S. college health centers.
This study provides an estimate of the prevalence of universal depression screening at public, 4-year universities in the United States. It also documents systems-level facilitators and correlates of universal screening, as well as reasons for not screening. Method: Online cross-sectional survey of college health center directors and student health personnel of public 4-year universities. Results: There were 131 participants who responded to the survey (25% response): 64.2% (54–74%; 95% confidence interval [CI]) of respondents reported that their clinics use universal depression screening. Characteristics associated ...
Source: Families, Systems, and Health - May 6, 2019 Category: International Medicine & Public Health Source Type: research

Treating pain in primary care: Optimizing an integrated psychological intervention based on perspectives of psychologists, primary care providers, and patients.
Discussion: Feedback solicited from the focus groups led to alterations to the treatment manual, such as adding a fifth session, using different psychological strategies, and logistical changes in delivery (i.e., meeting biweekly and intervisit contacts). The modified version of this intervention will be evaluated with a pilot randomized controlled clinical trial. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - May 6, 2019 Category: International Medicine & Public Health Source Type: research