Research Interests:
397 mon biopsychosocial factors that are associated with the development of dual disorders. • The high prevalence and related disability of dual disorders require active intervention from policy-makers at a systems level and active... more
397 mon biopsychosocial factors that are associated with the development of dual disorders. • The high prevalence and related disability of dual disorders require active intervention from policy-makers at a systems level and active advocacy from health professionals. • Service providers should be trained in the management of dual disorders and sufficient financial support should be granted for this purpose. • Systematic screening for other mental disorders through validated instruments by trained health service providers is an essential component of adequate care for people with drug use disorders. • Availability of and accessibility to adequate treatment should be provided, regardless of the entry point to care systems, in line with the principle of “no wrong door”. • Sexand gender-based knowledge and a stigma-free approach are required in the effective management of dual disorders. • Age-specific interventions are required across the lifespan, especially for minors and the elderly. • Science-informed prevention interventions that address common risk factors, such as early life adversity, should be available to children living with parents and/or caregivers with dual disorders. • Attention should also be given to other at-risk and vulnerable populations, in accordance with local needs. • Access to services for dual disorders in the criminal justice system, particularly in prison settings, youth detention or correctional centres, should be secured. • Collection and analysis of data to monitor the magnitude of the problem, the quality of care and the outcomes of policies and interventions should be encouraged. • Implementation and scale up of effective and efficient interventions, with consideration of cultural and country specificities, is a priority. • Finally, the Informal Scientific Network urges UN Member States to further support scientific research on new and enhanced interventions to effectively prevent and treat psychiatric comorbidities in people with drug use disorders.
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... Page 2. James Newton, Roger Masters, Gregory McHugo & Denis Sullivan 227 ... Page 4. James Newton, Roger Masters, Gregory McHugo & Denis Sullivan 229 in-depth issue analysis, which consumes valuable air time and threatens to... more
... Page 2. James Newton, Roger Masters, Gregory McHugo & Denis Sullivan 227 ... Page 4. James Newton, Roger Masters, Gregory McHugo & Denis Sullivan 229 in-depth issue analysis, which consumes valuable air time and threatens to bore viewers. ...
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Research Interests: Psychology, Clinical Psychology, Psychiatry, Addiction, Medicine, and 14 moreHumans, Substance Abuse, Female, Male, Middle Aged, Psychological Tests, Adult, Public health systems and services research, Sex Factors, Age Factors, Reproducibility of Results, Homeless Persons, Substance-Related Disorders, and Severity of Illness Index
Depressive symptoms have debilitating effects on the physical health and functioning of people with serious mental illness. We examined change in depressive symptoms among overweight and obese adults with serious mental illness (n = 343)... more
Depressive symptoms have debilitating effects on the physical health and functioning of people with serious mental illness. We examined change in depressive symptoms among overweight and obese adults with serious mental illness (n = 343) using data combined from two randomized trials comparing the 12-month In SHAPE program to a gym membership control condition. In SHAPE consists of a gym membership, weekly individual meetings with a fitness trainer, and instruction on healthy eating and nutrition. Depressive symptoms were measured at baseline, 3, 6, and 12 months. Change in depressive symptoms did not differ between groups, but depressive symptoms decreased over time across the entire sample (p = 0.045). At 12 months, reduced depressive symptoms were associated with clinically significant improved cardiorespiratory fitness (p = 0.030), 10% or more weight loss (p = 0.044), and cardiovascular risk reduction (p = 0.028) across both groups. Our findings suggest that participation in hea...
Research Interests: Psychology, Cognitive Science, Health Promotion, Mental Health, Depression, and 15 moreBipolar Disorder, Obesity, Medicine, Overweight, Humans, Female, Male, Clinical Sciences, Physical Fitness, Middle Aged, Adult, Cardiovascular Diseases, Psychotic Disorders, Depressive Symptoms, and Cardiorespiratory Fitness
The Dartmouth Primary Care Cooperative Information (COOP) Project conducted a controlled trial on the impact of antismoking advice from office-based physicians. Eighteen primary care medical practices were randomly assigned to be... more
The Dartmouth Primary Care Cooperative Information (COOP) Project conducted a controlled trial on the impact of antismoking advice from office-based physicians. Eighteen primary care medical practices were randomly assigned to be intervention or customary care practices. Medical personnel assigned to the intervention practices were to systematically identify cigarette smokers (among patients aged 35 to 59 years making an office visit), advise them to quit smoking, and provide educational materials. A random sample of 258 smokers was identified and followed-up four months later. Intervention-group smokers were more likely to report being advised to quit smoking (77 percent versus 47 percent) and to attempt quitting (39 percent versus 31 percent), but had success rates similar to those of the other group (6 percent versus 7 percent). We conclude that the medical office is an excellent place to identify large numbers of smokers and initiate attempts at quitting, but find that simple antismoking information and advice are not enough to improve cessation rates.
Research Interests: Primary Care, Education, Primary Health Care, Family Medicine, Family Practice, and 13 moreMedicine, Motivation, Humans, Smoking Cessation, Smoking, Female, Male, Quit Smoking, Middle Aged, Adult, Guidance and Counseling Intervention Programs, Clinical Trials as Topic, and Medical and Health Sciences
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Research Interests: Psychology, Health Informatics, Applied Research, Medicine, Latent Class Models, and 15 moreHumans, Substance Abuse, Female, Male, Group membership, Growth Analysis, Mental health services, Clinical Sciences, New Hampshire, Longitudinal Studies, Public health systems and services research, Mixture Model, Longitudinal data, Statistics as Topic, and Posterior probability
Research Interests: Psychiatry, Mental Health, Personality Disorders, Adolescent, Medicine, and 15 moreComorbidity, Prospective studies, Humans, Female, Male, Mental Disorders, Incidence, Mood Disorders, Middle Aged, Adult, Prognosis, Age Factors, Cross Sectional Studies, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers.... more
Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers. This study investigated domains of implementation activities and correlated them to implementation success during a large national evidence-based practice implementation project. Implementation success was correlated with active leadership strategically devoted to redesigning the flow of work and reinforcing implementation through measurement and feedback. Relative attention to workforce development was negatively correlated with implementation. Active leaders should focus on redesigning the flow of work to support the implementation and on reinforcing program improvements.
Research Interests: Psychology, Mental Health, Leadership, Health Informatics, Evidence Based Practice, and 15 moreWorkflow, Health Administration, Medicine, Workforce Development, Humans, Process management, Workforce, Mental Disorders, Clinical Sciences, Severe Mental Illness, Implementation Research, Public health systems and services research, Community Based Mental Health Services, Guideline Adherence, and reinforcement psychology
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Research Interests: Computer Graphics, Facial expression, Adolescent, Medicine, Mood, and 15 moreAffect, Humans, Child, Paediatric Anaesthesia, Female, Male, Postoperative pain, Pediatric Anaesthesia, Analysis of Variance, Pediatric Anesthesia, Pain Measurement, Pain Scale, Preoperative Period, Child preschool, and Paediatrics and reproductive medicine
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Employment may be an important factor in helping patients with early psychosis to recover rapidly and to avoid involvement in disability and welfare programs. This study followed 351 patients with early psychoses, either primary psychoses... more
Employment may be an important factor in helping patients with early psychosis to recover rapidly and to avoid involvement in disability and welfare programs. This study followed 351 patients with early psychoses, either primary psychoses or substance-induced psychoses, for two years to examine their patterns of competitive employment in relation to service use, psychosocial outcomes, and disability and welfare payments. Workers differed from non-workers at baseline and over two years. At baseline, they had better educational and employment histories, were more likely to have substance-induced psychoses rather than primary psychoses, were less likely to have drug dependence, had fewer negative symptoms, and had better psychosocial adjustment. Over two years, baseline psychosocial differences persisted, and the workers used fewer medications, mental health services, and disability or welfare payments. Employment predicts less service use and fewer disability claims among early psychosis patients. Thus, greater attention to supported employment early in the course of illness may reduce federal insurance costs and disability payments.
Research Interests: Psychology, Psychiatry, Psychosis, Schizophrenia, Employment, and 15 moreMedicine, Humans, Female, Male, Regression Analysis, Psychosocial, Longitudinal Studies, Adult, Payment, Psychotic Disorders, Self report, Disability Benefits, Disability Evaluation, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Program Evaluation, Psychology, Health Psychology, Social Work, Mental Health, and 15 moreCommunity-Based Mental Health Services, Evidence Based Practice, Forecasting, Public Health, Medicine, Humans, Diffusion of Innovation, Longitudinal Studies, Public health systems and services research, Longitudinal Study, Fidelity, Sustainability, Behavioral Health Services, Community Based Mental Health Services, and Guideline Adherence
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... R. Haslett a * , Robert E. Drake a , Gary R. Bond a , Deborah R. Becker a & Gregory J. McHugo a pages 237-244. ... The sparse published data on the matter are inconclusive. Drake et al. (19985. Drake , RE , Fox , TS ,... more
... R. Haslett a * , Robert E. Drake a , Gary R. Bond a , Deborah R. Becker a & Gregory J. McHugo a pages 237-244. ... The sparse published data on the matter are inconclusive. Drake et al. (19985. Drake , RE , Fox , TS , Leather , PK , Becker , DR , Musumeci , JS , et al. . ( 1998 ). ...
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... Services Administration (SAMHSA). Thanks also go to Pamela Robbins, Roumen Vesselinov, and William Shadish for their comments on an earlier version of this chapter. This research was supported by grant no. 280940008 ...
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Objective: We compared the validity of hospital admission and length of stay reports from patients, outpatient providers, and hospitals, and we examined possible sources of error. Data sources: Data were collected from people enrolled in... more
Objective: We compared the validity of hospital admission and length of stay reports from patients, outpatient providers, and hospitals, and we examined possible sources of error. Data sources: Data were collected from people enrolled in a randomized trial of treatment for severe mental illness and substance use disorders, from community mental health centers (CMHCs), and from hospitals. Reports for each of the 74 study participants covered two-year time periods beginning and ending at various times between 1989 and 1993. Study design: We compared reports from the various sources and constructed a hybrid with data from all three sources. Using parametric and non-parametric statistics, we compared patient, CMHC, and hospital reports with each other and with the hybrid source. In subsequent regression analyses we explored correlates of reporting accuracy. Principal findings: Single-source reports underestimated hospital use, but when patient and CMHC reports were combined, results were very similar to those obtained by the more laborious hybrid method. Patient reports became less accurate as the time between discharge and reporting increased; people with bipolar disorders reported admissions with greater accuracy than did people with schizophrenia. CMHC reporting accuracy decreased as the distance to the admitting hospital increased and were less accurate for people with more severe psychiatric symptoms. Conclusions: Reports from single sources are likely to underestimate hospital use for different reasons. Combining carefully collected data from patients and outpatient providers produces estimates of hospital use that are substantially the same as those developed through methods that are more laborious and costly.
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Research Interests: Psychology, Mental Health, Bipolar Disorder, Public Health, Health Services Research, and 15 moreMedicine, Humans, Assertive Community Treatment, Mental health services, Case Management, Length of Stay, Clinical Sciences, New Hampshire, Longitudinal Studies, Adult, Public health systems and services research, Health Services Administration, Health Care Utilization, Hospital Admission, and Random effects
Research Interests: Psychiatry, Mental Health, Bipolar Disorder, Obesity, Life Style, and 15 moreMedicine, Mental Illness, Humans, Female, Male, Psychological Intervention, Exercise, Mental Disorders, Middle Aged, Adult, Cardiovascular Diseases, Healthy Diet, Psychology and Cognitive Sciences, Medical and Health Sciences, and Fitness trackers
Research Interests: Business, Program Evaluation, Psychology, Mental Health, Adolescent, and 15 moreMedicine, Prospective studies, Humans, Program Development, Female, Male, Mental Disorders, Clinical Sciences, Community Mental Health, Serious Mental Illness, Middle Aged, Severe Mental Illness, Adult, Cross Section, and Cross Sectional Studies
Research Interests: Psychology, Clinical Psychology, Cognitive Science, Psychiatry, Psychometrics, and 15 moreEvolution, Dual Diagnosis, Medicine, Mental Illness, Substance Abuse Treatment, Humans, Substance Abuse, Hospitalization, Drug Addiction, Mental Disorders, Case Management, Clinical Sciences, Severe Mental Illness, Reproducibility of Results, and Psychiatric Status Rating Scales
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Research Interests: Clinical Psychology, Psychiatry, Clinical Trial, Health Education, Dual Diagnosis, and 15 moreConsulting, Adolescent, Group Psychotherapy, Medicine, Comorbidity, Humans, Personality Assessment Inventory, Posttraumatic stress disorder, Female, Cognitive Therapy, Cognitive Behavioral Treatment Method, Aged, Middle Aged, Adult, and Behavioral Intervention
Lack of standardization in statistical reporting is ubiquitous within the medical and social science fields, leading to inconsistencies and shortcomings that substantially detract from the contributions of scientific investigations. We... more
Lack of standardization in statistical reporting is ubiquitous within the medical and social science fields, leading to inconsistencies and shortcomings that substantially detract from the contributions of scientific investigations. We suggest that the Archives of Physical Medicine and Rehabilitation, following the example of other journals, ~'2 publish in its "Information for Authors" a set of explicit standards for statistical reporting, to ensure uniformity, completeness, and accuracy. At the outset, we acknowledge the need for flexibility. Except for the simplest of requirements, no single rule will fit all studies. Nor can any set of guidelines substitute for creativity, common sense, or good judgment. We do, however, recommend that authors and manuscript peer reviewers become familiar with the Publication Manual of the American Psychological Association, 3 which has general statistical reporting guidelines and which provides many examples and details on a range of reporting issues. We suggest that authors submitting their work to the Archives pay particular attention to the following.
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Research Interests: Business, Program Evaluation, Psychology, Philosophy of Agency, Leadership, and 13 morePublic Relations, Workflow, Medicine, Prospective studies, Humans, Program Development, Supported Employment, United States, Workforce, Government Agencies, Clinical Sciences, Public health systems and services research, and Residence Characteristics
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ABSTRACT
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There is a growing call for greater consumer participation in health care encounters. Prior research suggests that older age is associated with a greater preference for a more passive role in clinical decision-making, yet little is known... more
There is a growing call for greater consumer participation in health care encounters. Prior research suggests that older age is associated with a greater preference for a more passive role in clinical decision-making, yet little is known about preferences for persons with mental illness. This pilot study compared preferences for involvement in decision-making between older and younger adults with serious mental illness. Cross-sectional observational survey. The authors surveyed 33 older adults (>or=50 years) and 32 younger adults (<50 years) with serious mental illness from two mental health center clinics and one residential facility for their preferences on decision-making with their psychiatrists and primary care providers. Measures included the Control Preferences Scale, the Autonomy Preference Index, and the Decision Self-Efficacy Scale. Contrary to our primary hypothesis, older adults reported a stronger desire for involvement in decision-making compared with younger adults. However, both age groups were similar in their desire for information to aid in decision-making. The majority in both age groups also preferred a collaborative role with a psychiatrist for medication decisions, an autonomous role for decisions related to psychosocial interventions, and a passive role with their primary care provider. Older and younger adults expressed similar decision self-efficacy. Our study suggests that older persons with serious mental illness have a stronger desire for involvement in decision-making than younger consumers. Additionally, role preference for involvement in decision-making varies across different clinical decisions and for psychopharmacological versus psychosocial interventions.
Research Interests: Decision Making, Mental Health, Autonomy, Medicine, Mental Illness, and 15 moreHumans, Female, Male, American, Mental Disorders, Mental health services, Clinical Sciences, New Hampshire, Mood Disorders, Aged, Middle Aged, Educational Status, Patient Participation, Cross Sectional Studies, and Community Based Mental Health Services
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Research Interests: Psychology, Community-Based Mental Health Services, Evidence Based Medicine, Public sector, Vocational Education, and 11 moreMedicine, Humans, Supported Employment, United States, Diffusion of Innovation, Psychiatric Rehabilitation, Clinical Sciences, Supervisor, Fidelity, Community Based Mental Health Services, and Guideline Adherence
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Research Interests:
397 mon biopsychosocial factors that are associated with the development of dual disorders. • The high prevalence and related disability of dual disorders require active intervention from policy-makers at a systems level and active... more
397 mon biopsychosocial factors that are associated with the development of dual disorders. • The high prevalence and related disability of dual disorders require active intervention from policy-makers at a systems level and active advocacy from health professionals. • Service providers should be trained in the management of dual disorders and sufficient financial support should be granted for this purpose. • Systematic screening for other mental disorders through validated instruments by trained health service providers is an essential component of adequate care for people with drug use disorders. • Availability of and accessibility to adequate treatment should be provided, regardless of the entry point to care systems, in line with the principle of “no wrong door”. • Sexand gender-based knowledge and a stigma-free approach are required in the effective management of dual disorders. • Age-specific interventions are required across the lifespan, especially for minors and the elderly. • Science-informed prevention interventions that address common risk factors, such as early life adversity, should be available to children living with parents and/or caregivers with dual disorders. • Attention should also be given to other at-risk and vulnerable populations, in accordance with local needs. • Access to services for dual disorders in the criminal justice system, particularly in prison settings, youth detention or correctional centres, should be secured. • Collection and analysis of data to monitor the magnitude of the problem, the quality of care and the outcomes of policies and interventions should be encouraged. • Implementation and scale up of effective and efficient interventions, with consideration of cultural and country specificities, is a priority. • Finally, the Informal Scientific Network urges UN Member States to further support scientific research on new and enhanced interventions to effectively prevent and treat psychiatric comorbidities in people with drug use disorders.
Research Interests:
Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are... more
Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are needed to complement fidelity scales measuring structural aspects of program implementation. As part of the instrumentation developed for the National Implementing Evidence-Based Practices Project, we piloted a new instrument with two 5-item quality scales, Individualization (a client-level quality scale) and Quality Improvement (an organizational-level quality scale). Pairs of independent fidelity assessors conducted fidelity reviews in 49 sites in 8 states at baseline and at four subsequent 6-month intervals over a 2-year follow-up period. The assessors followed a standardized protocol to administer these quality scales during daylong site visits; during these same visits they assessed programs on fidelity to the evidence-based practice that the site was seeking to implement. Assessors achieved acceptable interrater reliability for both Individualization and Quality Improvement. Principal components factor analysis confirmed the 2-scale structure. The two scales were modestly correlated with each other and with the evidence-based practice fidelity scales. Over the first year, Individualization and Quality Improvement improved, but showed little or no improvement during the last year of follow-up. The two newly developed scales showed adequate psychometric properties in this preliminary study, but further research is needed to assess their validity and utility in routine clinical practice.
Research Interests: Psychology, Psychometrics, Evidence Based Medicine, Evidence Based Practice, Principal Component Analysis, and 15 moreQuality Improvement, Health Services Research, Medicine, Clinical Practice, Factor analysis, Humans, Mental health services, Psychometric Properties, Clinical Sciences, Observer Variation, Public Administration and Policy, Public health systems and services research, First Year, Fidelity, and quality assurance in health care
Research Interests: Psychology, Community-Based Mental Health Services, Data Analysis, Health Care, Public Health, and 14 moreHealth Services Research, Research, Medicine, Humans, Data Interpretation, Assertive Community Treatment, Psychotic Disorder, Health Services Administration, Psychotic Disorders, Process Evaluation, Deinstitutionalization, Invocation, Bias (Epidemiology), and Community Based Mental Health Services
Research Interests: Psychology, Clinical Psychology, Psychiatry, Mental Health, Quality of life, and 15 moreEmpowerment, Dual Diagnosis, History of Physics, Autonomy, Public Health, Medicine, Anxiety, Population, Posttraumatic stress disorder, Drug Addiction, Drug abuse, Experimental Study, Serious Mental Illness, ANXIETY, and Dual
Research Interests: Psychiatry, Mental Health, Bipolar Disorder, Dual Diagnosis, Medicine, and 15 moreComorbidity, Activities of Daily Living, Biological Sciences, Biological Psychiatry, Independent Living, Humans, Hospitalization, Female, Male, New Hampshire, Adult, Occupations, Psychiatric Status Rating Scales, Health Resources, and Medical and Health Sciences
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Analysis of network news during the 1984 presidential campaign shows that TV coverage of Democratic candidates differed in frequency and in the kinds of expressive displays shown over the course of the pre-convention period. Although... more
Analysis of network news during the 1984 presidential campaign shows that TV coverage of Democratic candidates differed in frequency and in the kinds of expressive displays shown over the course of the pre-convention period. Although political success was generally correlated with media attention, as predicted on the basis of ethology, Jackson was more successful than Mondale in becoming the unquestioned focus of news coverage. Ethological predictions of the type of display behavior shown were generally consistent with the data: happy/reassurance displays were more frequent in interviews, whereas anger/threat tended to be shown more often during speeches, and political success was generally associated with an increased frequency of happy/reassurance displays. Combined with experimental results reported elsewhere, these findings help to explain the outcome of the 1984 campaign and suggest that nonverbal leadership cues are an element in the influence of television in contemporary politics.