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Wagner A, Caplan L, Juliano-Bult D, Williams N. Improving the Rigor of Research on Autism in Adulthood Requires Valid and Reliable Measurement Tools. Autism Adulthood 2020; 2:174-176. [PMID: 35005453 PMCID: PMC8730294 DOI: 10.1089/aut.2020.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Ann Wagner
- Office of the Director, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA.,Address correspondence to: Ann Wagner, PhD, Office of the Director, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, 6001 Executive Boulevard, Room 6219B, Rockville, MD 20852, USA
| | - Leslie Caplan
- National Institute on Disability, Independent Living, and Rehabilitation Resources, Administration for Community Living, Department of Health and Human Services, Washington, District of Columbia, USA
| | - Denise Juliano-Bult
- Division of Services and Interventions Research, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Nicole Williams
- Department of Defense, Congressionally Directed Medical Research Programs, Fort Detrick, Maryland, USA
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Chambers DA, Pintello D, Juliano-Bult D. Capacity-building and training opportunities for implementation science in mental health. Psychiatry Res 2020; 283:112511. [PMID: 31439403 DOI: 10.1016/j.psychres.2019.112511] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022]
Abstract
This article traces efforts over the past decade by the National Institute of Mental Health, of the US National Institutes of Health, and other US organizations to build capacity for mental health researchers to advance activities in implementation science. Authors briefly chronicle the antecedents to the field's growth, and describe funding opportunities, workshop and conferences, training programs, and other initiatives that have collectively engaged hundreds of mental health researchers in the development and execution of implementation studies across the breadth of contexts where mental health care and prevention programs are delivered to those in need. The authors summarize a number of key initiatives and present potential next steps to further build the capacity for a new generation of implementation studies in mental health.
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Affiliation(s)
- David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 3E414, Rockville, MD 20850, United States.
| | - Denise Pintello
- Division of Services and Interventions Research, National Institute of Mental Health, United States.
| | - Denise Juliano-Bult
- Division of Services and Interventions Research, National Institute of Mental Health, United States.
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Rupp A, Freed MC, Juliano-Bult D. PERSPECTIVES: Insurance markets, labor markets, and the mental health services delivery system. J Ment Health Policy Econ 2019; 22:151-154. [PMID: 32058978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The authors are health scientist administrators at the National Institute of Mental Health (NIMH). The mission of NIMH is "to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure." As part of its portfolio, NIMH supports research on mental health economics, and mental health services research. METHOD In this perspective article, the authors comment on two papers presented at the NIMH-sponsored Mental Health Services Research Conference in 2018 and subsequently published in the September 2019 issue of the Journal of Mental Health Policy and Economics. Two important areas are highlighted in this review: (i) the impact of insurance and labor markets on the delivery of high-quality mental health services, and (ii) the need for advancements in method development and design in future studies. DISCUSSION The complexity of health insurance markets created some unintended consequence of the mental health insurance parity legislation. Mental health provider shortages in local labor markets are a barrier to successful implementation and sustainment of innovative and evidence-based mental health service-delivery models for people with serious mental illness. IMPLICATIONS FOR RESEARCH Data-capture techniques that seamlessly integrate insurance claims with clinical outcomes (e.g., from electronic health records) will better equip health economists and other end-users with rigorous research findings to inform public health policy and practice recommendations. Despite early signals of success, larger sample sizes and more rigorous research designs are needed to refine predictive models of functional outcomes of evidence-based service-delivery models (e.g., coordinated specialty care model including supported education, and supported employment) for people with first-episode psychosis.
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Affiliation(s)
- Agnes Rupp
- NIMH/NIH 9000 Rockville Pike, Bethesda, MD 20892, USA,
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O’Mara A, Rowland JH, Greenwell TN, Wiggs CL, Fleg J, Joseph L, McGowan J, Panagis JS, Washabaugh C, Peng GCY, Bray R, Cernich AN, Cruz TH, Marden S, Michel ME, Nitkin R, Quatrano L, Spong CY, Shekim L, Jones TLZ, Juliano-Bult D, Panchinson DM, Chen D, Jakeman L, Knebel A, Tully LA, Chan L, Damiano D, Tian B, McInnes P, Khalsa P, Reider E, Shurtleff D, Elwood W, Ballard R, Ershow AG, Begg L. National Institutes of Health Research Plan on Rehabilitation: NIH Medical Rehabilitation Coordinating Committee. Phys Ther 2017; 97:104-407. [PMID: 28499003 PMCID: PMC5436691 DOI: 10.1093/ptj/pzx026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation.This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: NIH Medical Rehabilitation Coordinating Committee. Am J Phys Med Rehabil. 2017;97(4):404-407.
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Affiliation(s)
| | | | | | | | | | - Jerome Fleg
- National Heart, Lung, and Blood Institute (NHLBI)
| | | | - Joan McGowan
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
| | - James S. Panagis
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
| | - Charles Washabaugh
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
| | - Grace C. Y. Peng
- National Institute of Biomedical Imaging and Bioengineering (NIBIB)
| | - Rosalina Bray
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Alison N. Cernich
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Theresa H. Cruz
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Sue Marden
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Mary Ellen Michel
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Ralph Nitkin
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Louis Quatrano
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Catherine Y. Spong
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
| | - Lana Shekim
- National Institute on Deafness and Other Communication Disorders (NIDCD)
| | - Teresa L. Z. Jones
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
| | | | | | - Daofen Chen
- National Institute of Neurological Disorders and Stroke (NINDS)
| | - Lyn Jakeman
- National Institute of Neurological Disorders and Stroke (NINDS)
| | - Ann Knebel
- National Institute of Nursing Research (NINR)
| | | | | | | | | | - Pamela McInnes
- National Center for Advancing Translational Sciences (NCATS)
| | - Partap Khalsa
- National Center for Complementary and Integrative Health (NCCIH)
| | - Eve Reider
- National Center for Complementary and Integrative Health (NCCIH)
| | - David Shurtleff
- National Center for Complementary and Integrative Health (NCCIH)
| | - William Elwood
- Offices of the Director, Division of Program Coordination, Planning, and Strategic Initiatives (DPCPSI)
| | | | | | - Lisa Begg
- Office of Research on Women's Health (ORWH)—all in Bethesda, MD
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McGinty EE, Baller J, Azrin ST, Juliano-Bult D, Daumit GL. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review. Schizophr Bull 2016; 42. [PMID: 26221050 PMCID: PMC4681556 DOI: 10.1093/schbul/sbv101] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings.
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Affiliation(s)
- Emma E. McGinty
- Departments of Health Policy and Management and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;,*To whom correspondence should be addressed; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 359, Baltimore, MD 21205, US; tel: 410-614-4018, e-mail:
| | - Julia Baller
- Departments of Health Policy and Management and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Gail L. Daumit
- Division of General Internal Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD
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Evans JD, Juliano-Bult D, Lee SY. Health Disparities Research in Geriatric Mental Health: Commentary from the National Institute of Mental Health. Am J Geriatr Psychiatry 2015; 23:655-7. [PMID: 26055317 DOI: 10.1016/j.jagp.2015.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 01/31/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Jovier D Evans
- Division of Translational Research, National Institute of Mental Health, Rockville, MD.
| | - Denise Juliano-Bult
- Division of Services and Interventions Research, National Institute of Mental Health, Rockville, MD
| | - Su Yeon Lee
- Office for Research on Disparities and Global Mental Health, National Institute of Mental Health, Rockville, MD
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McGinty EE, Baller J, Azrin ST, Juliano-Bult D, Daumit GL. Quality of medical care for persons with serious mental illness: A comprehensive review. Schizophr Res 2015; 165:227-35. [PMID: 25936686 PMCID: PMC4670551 DOI: 10.1016/j.schres.2015.04.010] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/02/2015] [Accepted: 04/09/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Prior studies suggest variation in the quality of medical care for somatic conditions such as cardiovascular disease and diabetes provided to persons with SMI, but to date no comprehensive review of the literature has been conducted. The goals of this review were to summarize the prior research on quality of medical care for the United States population with SMI; identify potential sources of variation in quality of care; and identify priorities for future research. METHODS Peer-reviewed studies were identified by searching four major research databases and subsequent reference searches of retrieved articles. All studies assessing quality of care for cardiovascular disease, diabetes, dyslipidemia, and HIV/AIDs among persons with schizophrenia and bipolar disorder published between January 2000 and December 2013 were included. Quality indicators and information about the study population and setting were abstracted by two trained reviewers. RESULTS Quality of medical care in the population with SMI varied by study population, time period, and setting. Rates of guideline-concordant care tended to be higher among veterans and lower among Medicaid beneficiaries. In many study samples with SMI, rates of guideline adherence were considerably lower than estimated rates for the overall US population. CONCLUSIONS Future research should identify and address modifiable provider, insurer, and delivery system factors that contribute to poor quality of medical care among persons with SMI and examine whether adherence to clinical guidelines leads to improved health and disability outcomes in this vulnerable group.
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Affiliation(s)
- Emma E McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 359, Baltimore, MD 21205, United States.
| | - Julia Baller
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 359, Baltimore, MD 21205, United States.
| | | | - Denise Juliano-Bult
- Johns Hopkins Medical Institutions, Division of General Internal Medicine, Welch Center for Prevention, Epidemiology and Clinical Research, United States.
| | - Gail L Daumit
- Johns Hopkins Medical Institutions, Division of General Internal Medicine, Welch Center for Prevention, Epidemiology and Clinical Research, United States.
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Janssen EM, McGinty EE, Azrin ST, Juliano-Bult D, Daumit GL. Review of the evidence: prevalence of medical conditions in the United States population with serious mental illness. Gen Hosp Psychiatry 2015; 37:199-222. [PMID: 25881768 PMCID: PMC4663043 DOI: 10.1016/j.genhosppsych.2015.03.004] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/25/2015] [Accepted: 03/05/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Persons with serious mental illness (SMI) have high rates of premature mortality from preventable medical conditions, but this group is underrepresented in epidemiologic surveys and we lack national estimates of the prevalence of conditions such as obesity and diabetes in this group. We performed a comprehensive review to synthesize estimates of the prevalence of 15 medical conditions among the population with SMI. METHOD We reviewed studies published in the peer-reviewed literature from January 2000 to August 2012. Studies were included if they assessed prevalence in a sample of 100 or more United States (US) adults with schizophrenia or bipolar disorder. RESULTS A total of 57 studies were included in the review. For most medical conditions, the prevalence estimates varied considerably. For example, estimates of obesity prevalence ranged from 26% to 55%. This variation appeared to be due to differences in measurement (e.g., self-report versus clinical measures) and underlying differences in study populations. Few studies assessed prevalence in representative, community samples of persons with SMI. CONCLUSIONS In many studies, the prevalence of medical conditions among the population with SMI was higher than among the overall US population. Screening for and monitoring of these conditions should be common practice in clinical settings serving persons with SMI.
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Affiliation(s)
- Ellen M Janssen
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA.
| | - Emma E McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 359, Baltimore, MD 21205, USA.
| | - Susan T Azrin
- National Institute of Mental Health, 6001 Executive Boulevard, Room 7145 MSC 9631, Rockville, MD 20852, USA.
| | - Denise Juliano-Bult
- National Institute of Mental Health, 6001 Executive Boulevard, Room 7144 MSC 9631, Rockville, MD 20852, USA.
| | - Gail L Daumit
- Division of General Internal Medicine, Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-620, Baltimore, MD 21205, USA.
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Chambers DA, Pringle B, Juliano-Bult D. Connecting Science and Practice in Child and Adolescent Mental Health Services Research. Adm Policy Ment Health 2012; 39:321-6. [DOI: 10.1007/s10488-011-0399-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chandler RK, Peters RH, Field G, Juliano-Bult D. Challenges in implementing evidence-based treatment practices for co-occurring disorders in the criminal justice system. Behav Sci Law 2004; 22:431-448. [PMID: 15282833 DOI: 10.1002/bsl.598] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The presence of adults with mental health and substance abuse disorders within the criminal justice system has become increasingly evident over the past decade. Interventions and treatment services have been designed and research conducted in an effort to establish evidence-based practices that effectively address the complex needs of this population. However, adopting and implementing these evidence-based interventions and practices within the real-world setting of criminal justice environments is challenging. This article reviews the research literature related to evidence-based treatment practices for offenders with co-occurring mental health and substance abuse disorders and explores the inherent challenges of fitting these interventions and services within criminal justice settings.
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Affiliation(s)
- Redonna K Chandler
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
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