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Davis M, Dysart GC, Doupnik SK, Hamm ME, Schwartz KTG, George-Milford B, Ryan ND, Melhem NM, Stepp SD, Brent DA, Young JF. Adolescent, Parent, and Provider Perceptions of a Predictive Algorithm to Identify Adolescent Suicide Risk in Primary Care. Acad Pediatr 2024; 24:645-653. [PMID: 38190885 PMCID: PMC11056301 DOI: 10.1016/j.acap.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/12/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To understand adolescent, parent, and provider perceptions of a machine learning algorithm for detecting adolescent suicide risk prior to its implementation primary care. METHODS We conducted semi-structured, qualitative interviews with adolescents (n = 9), parents (n = 12), and providers (n = 10; mixture of behavioral health and primary care providers) across two major health systems. Interviews were audio recorded and transcribed with analyses supported by use of NVivo. A codebook was developed combining codes derived inductively from interview transcripts and deductively from implementation science frameworks for content analysis. RESULTS Reactions to the algorithm were mixed. While many participants expressed privacy concerns, they believed the algorithm could be clinically useful for identifying adolescents at risk for suicide and facilitating follow-up. Parents' past experiences with their adolescents' suicidal thoughts and behaviors contributed to their openness to the algorithm. Results also aligned with several key Consolidated Framework for Implementation Research domains. For example, providers mentioned barriers inherent to the primary care setting such as time and resource constraints likely to impact algorithm implementation. Participants also cited a climate of mistrust of science and health care as potential barriers. CONCLUSIONS Findings shed light on factors that warrant consideration to promote successful implementation of suicide predictive algorithms in pediatric primary care. By attending to perspectives of potential end users prior to the development and testing of the algorithm, we can ensure that the risk prediction methods will be well-suited to the providers who would be interacting with them and the families who could benefit.
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Affiliation(s)
- Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, GC Dysart, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; PolicyLab (M Davis, GC Dysart, SK Doupnik, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (M Davis and SK Doupnik), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Psychiatry (M Davis and JF Young), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI) (M Davis and SK Doupnik), University of Pennsylvania, Philadelphia, Pa.
| | - Gillian C Dysart
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, GC Dysart, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; PolicyLab (M Davis, GC Dysart, SK Doupnik, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Stephanie K Doupnik
- PolicyLab (M Davis, GC Dysart, SK Doupnik, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (M Davis and SK Doupnik), Children's Hospital of Philadelphia, Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI) (M Davis and SK Doupnik), University of Pennsylvania, Philadelphia, Pa; Division of General Pediatrics (SK Doupnik), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SK Doupnik), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa
| | - Megan E Hamm
- Department of Medicine (ME Hamm), University of Pittsburgh, Pittsburgh, Pa
| | - Karen T G Schwartz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, GC Dysart, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; PolicyLab (M Davis, GC Dysart, SK Doupnik, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Brandie George-Milford
- University of Pittsburgh Medical Center Western Psychiatric Hospital (B George-Milford and DA Brent), Pittsburgh, Pa
| | - Neal D Ryan
- Department of Psychiatry (ND Ryan, NM Melhem, SD Stepp, and DA Brent), University of Pittsburgh School of Medicine, Pittsburgh, Pa; Clinical and Translational Science Institute (ND Ryan), University of Pittsburgh, Pittsburgh, Pa
| | - Nadine M Melhem
- Department of Psychiatry (ND Ryan, NM Melhem, SD Stepp, and DA Brent), University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Stephanie D Stepp
- Department of Psychiatry (ND Ryan, NM Melhem, SD Stepp, and DA Brent), University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - David A Brent
- University of Pittsburgh Medical Center Western Psychiatric Hospital (B George-Milford and DA Brent), Pittsburgh, Pa; Department of Psychiatry (ND Ryan, NM Melhem, SD Stepp, and DA Brent), University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, GC Dysart, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; PolicyLab (M Davis, GC Dysart, SK Doupnik, KTG Schwartz, and JF Young), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Psychiatry (M Davis and JF Young), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa
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Jones JD, Schwartz KTG, Davis M, Gallop R, Hankin BL, Young JF. Cognitive and interpersonal moderators of two evidence-based depression prevention programs. J Consult Clin Psychol 2024:2024-74438-001. [PMID: 38635190 DOI: 10.1037/ccp0000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. METHOD Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive-behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy-Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent-adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. RESULTS After adjusting for multiple comparisons, rumination (B = -2.02, SE = .61, p = .001, d = .47), hopelessness (B = -2.03, SE = .72, p = .005, d = .41), and conflict with father (B = 1.68, SE = .74, p = .02, d = .32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. CONCLUSIONS These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | - Karen T G Schwartz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | | | | | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
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Davis M, Jones JD, Schwartz KTG, Dysart G, So A, Young JF. Emerging Risk of Adolescent Depression and Suicide Detected Through Pediatric Primary Care Screening. J Pediatr Psychol 2024; 49:111-119. [PMID: 38001561 DOI: 10.1093/jpepsy/jsad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE The goal of the current study was to document patterns of stability and change in adolescent depression and suicide risk detected via universal depression screening in pediatric primary care and to determine who may go on to experience emerging risk. METHODS Retrospective electronic health record information (sociodemographic data and depression screening results for 2 timepoints) was extracted for adolescents aged 12-17 who attended well-visits between November 15, 2017, and February 1, 2020, in a large pediatric primary care network. A total of 27,335 adolescents with 2 completed depression screeners were included in the current study. RESULTS While most adolescents remained at low risk for depression and suicide across the 2 timepoints, others experienced emerging risk (i.e., low risk at time 1 but elevated risk at time 2), decreasing risk (i.e., high risk at time 1 but low risk at time 2) or stable high risk for depression or suicide. Odds of experiencing emerging depression and suicide risk were higher among adolescents who were female (compared to males), Black (compared to White), and had Medicaid insurance (compared to private insurance). Odds of experiencing emerging depression risk were also higher among older adolescents (compared to younger adolescents) as well as adolescents who identified as Hispanic/Latino (compared to non-Hispanic/Latino). CONCLUSIONS Findings can inform symptom monitoring and opportunities for prevention in primary care.
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Affiliation(s)
- Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
- Clinical Futures, Children's Hospital of Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, USA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, USA
| | - Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, USA
| | - Karen T G Schwartz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - Gillian Dysart
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - Amy So
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, USA
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Davis M, Jones JD, Gallop R, So A, Dysart G, Young JF. Adolescent Depression Symptom Trajectories Detected Via Universal Screening in Pediatric Primary Care. Res Child Adolesc Psychopathol 2024; 52:183-194. [PMID: 37642920 DOI: 10.1007/s10802-023-01116-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
Unique trajectories of adolescent depression symptoms have been identified, yet less is known about whether such patterns translate to real-world clinical settings. Because annual adolescent depression screening is becoming more prevalent in primary care, we examined whether longitudinal patterns of depression symptoms documented in the developmental psychopathology literature can also be detected via routine screening in primary care and explored how membership in the identified trajectories varied based on concurrent suicide risk and sociodemographic factors. A total of 1,359 adolescents aged 12-16 years old at the first timepoint were included in the current analyses. These adolescents completed three depression screeners during their well-visits in a large pediatric primary care network between November 15, 2017 and February 1, 2020. Retrospective electronic health record data were extracted, including sociodemographic variables and depression screening results. Dynamic functional time series clustering results indicated the optimal number of clusters was five. The five depression symptom trajectories were: (1) A-Shaped (i.e., relatively low depression symptoms at Time 1, a substantial increase in symptoms at Time 2, and a return to low symptoms at Time 3), (2) Increasing, (3) Low-Stable, (4) High-Decreasing, and (5) Low-Decreasing. Cluster differences in suicide risk largely mapped onto depression symptom levels at each assessment. We found cluster differences based on practice location, insurance type, and adolescent race. The symptom trajectories observed in this study resemble those found in the developmental psychopathology literature, though some key differences were noted. Findings can inform future research and symptom monitoring in primary care.
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Affiliation(s)
- Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA.
| | - Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Robert Gallop
- Department of Mathematics, West Chester University, West Chester, PA, USA
| | - Amy So
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Psychology Department at Montclair State University, Montclair, NJ, USA
| | - Gillian Dysart
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Postiglione AE, Delange AM, Ali MF, Houben M, Wang EY, Hahn SL, Roark CM, Davis M, Reid RW, Pease JB, Loraine AE, Muday GK. Flavonols improve thermotolerance in tomato pollen during germination and tube elongation by maintaining ROS homeostasis. bioRxiv 2023:2023.12.23.573189. [PMID: 38187649 PMCID: PMC10769439 DOI: 10.1101/2023.12.23.573189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Elevated temperatures impair pollen performance and reproductive success, resulting in lower crop yields. The Solanum lycopersicum anthocyanin reduced (are) mutant has a defect in the FLAVANONE 3 HYDROXYLASE (F3H) gene and impaired synthesis of flavonol antioxidants. We identified multiple aspects of pollen performance in are that were hypersensitive to elevated temperatures relative to the VF36 parental line, including heat-increased accumulation of reactive oxygen species (ROS). Transformation of are with an F3H transgene, or chemical complementation with flavonols, prevented temperature-dependent ROS accumulation in pollen and restored pollen performance to VF36 levels. Transformation of this F3H construct into VF36 (VF36-F3H-T3) prevented both temperature driven ROS increases and impaired pollen performance. RNA-Seq was performed at optimal and stress temperatures in are, VF36, and VF36-F3H-T3 at multiple timepoints across pollen tube emergence and elongation. All genotypes had increasing numbers of differentially expressed genes with duration of elevated temperature, with the largest number in are at all time points. These analyses also identified upregulated transcripts in are, relative to VF36, even at optimal temperatures, revealing a flavonol-regulated transcriptome. These findings suggest potential agricultural interventions to combat the negative effects of heat-induced ROS in pollen that leads to reproductive failure and crop loss.
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Affiliation(s)
- Anthony E. Postiglione
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Allison M. Delange
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Mohammad Foteh Ali
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Maarten Houben
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Eric Y. Wang
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Stacy L. Hahn
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Colleen M. Roark
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Molly Davis
- University of North Carolina, Department of Bioinformatics and Genomics, Charlotte, NC
| | - Robert W. Reid
- University of North Carolina, Department of Bioinformatics and Genomics, Charlotte, NC
| | - James B. Pease
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
| | - Ann E. Loraine
- University of North Carolina, Department of Bioinformatics and Genomics, Charlotte, NC
| | - Gloria K. Muday
- Wake Forest University, Department of Biology and Center for Molecular Signaling, Winston Salem, NC
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Esposito J, Davis M, Boyd RC. Suicide Prevention in Pediatric Health Care Settings. Pediatr Clin North Am 2023; 70:1115-1124. [PMID: 37865434 DOI: 10.1016/j.pcl.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Given recent trends demonstrating increased suicide risk among youth, particularly those from minoritized populations, youth suicide is a major public health concern. Evidence-based practices for the identification and management of youth suicide risk have been developed, yet many challenges exist to implementing them routinely in health care settings. Suggestions for leveraging publicly available resources, gathering input from a range of stakeholders to inform implementation, and enhancing multidisciplinary collaboration are provided with the aim of offering tangible steps toward addressing the youth suicide crisis.
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Affiliation(s)
- Jeremy Esposito
- Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA; Department of PolicyLab, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, USA
| | - Rhonda C Boyd
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA; Department of PolicyLab, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Hamdan SZ, Davis M, Faig W, Guthrie W, Yerys BE, Wallis KE. Lower Completion of Depression Screening and Higher Positivity Among Autistic Adolescents Across a Large Pediatric Primary Care Network. Acad Pediatr 2023; 23:1561-1571. [PMID: 37393034 PMCID: PMC10755081 DOI: 10.1016/j.acap.2023.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/15/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE To examine rates of depression screening and positivity among autistic adolescents where electronic depression screening is administered universally; to compare rates between autistic and nonautistic youth; and to explore sociodemographic and clinical factors associated with screening completion and results. METHODS We conducted a retrospective cohort study comparing 12-17-year-old autistic and nonautistic adolescents presenting for well-child care in a large pediatric primary care network between November 2017 and January 2019 (N = 60,181). Sociodemographic and clinical data, including PHQ-9-M completion status and results, were extracted digitally from the electronic health record and compared between autistic and nonautistic youth. Logistic regression explored the relationship between sociodemographic and clinical factors and screen completion and results, stratified by autism diagnosis. RESULTS Autistic adolescents were significantly less likely to have a completed depression screen compared to nonautistic adolescents [67.0% vs 78.9%, odds ratio (OR) = 0.54, P < .01]. Among those with a completed screen, a higher percentage of autistic youths screened positive for depression (39.1% vs 22.8%; OR = 2.18, P < .01,) and suicidal ideation/behavior (13.4% vs 6.8%; OR = 2.13, P < .01). Factors associated with screening completion and positivity differed between autistic and nonautistic groups. CONCLUSIONS Autistic adolescents were less likely to have a completed depression screen when presenting for well-child care. However, when screened, they were more likely to endorse depression and suicide risk. This suggests disparities in depression screening and risk among autistic youth compared to nonautistic youth. Additional research should evaluate the source of these disparities, explore barriers to screening, and examine longitudinal outcomes of positive results among this population.
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Affiliation(s)
- Samar Z Hamdan
- Division of Developmental and Behavioral Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
| | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, W Guthrie, and BE Yerys), Children's Hospital of Philadelphia, Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI) (M Davis), University of Pennsylvania, Philadelphia, Pa; Department of Psychiatry (M Davis, W Guthrie, and BE Yerys), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
| | - Walter Faig
- Biostatistics and Data Management Core (W Faig), Children's Hospital of Philadelphia, Philadelphia, Pa.
| | - Whitney Guthrie
- Division of Developmental and Behavioral Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, W Guthrie, and BE Yerys), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Psychiatry (M Davis, W Guthrie, and BE Yerys), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Center for Autism Research (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Hamdan is now with the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
| | - Benjamin E Yerys
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, W Guthrie, and BE Yerys), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Psychiatry (M Davis, W Guthrie, and BE Yerys), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Center for Autism Research (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Hamdan is now with the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
| | - Kate E Wallis
- Division of Developmental and Behavioral Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Center for Autism Research (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Hamdan is now with the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
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Meyer CH, Grant A, Sola R, Gills K, Mora A, Tracy BM, Muralidharan VJ, Koganti D, Todd SR, Butler C, Nguyen J, Hurst S, Udobi K, Sciarretta J, Williams K, Davis M, Dente C, Benjamin E, Ayoung-Chee P, Smith RN. Corrigendum to "Presentation, clinical course and complications in trauma patients with concomitant COVID-19 infection" [Am J Surg 224 (1 Pt B) (2022) 607-611]. Am J Surg 2023; 226:297. [PMID: 36384987 PMCID: PMC9659325 DOI: 10.1016/j.amjsurg.2022.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- C H Meyer
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - A Grant
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - R Sola
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - K Gills
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - A Mora
- Emory University School of Medicine, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - B M Tracy
- The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | | | - D Koganti
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - S R Todd
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - C Butler
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - J Nguyen
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - S Hurst
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - K Udobi
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - J Sciarretta
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - K Williams
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - M Davis
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - C Dente
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - E Benjamin
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - P Ayoung-Chee
- Grady Health System, Atlanta, GA, United States; Morehouse School of Medicine, Atlanta, GA, United States
| | - R N Smith
- Grady Health System, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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Hannan C, Mayne SL, Kelly MK, Davis M, Young JF, Powell M, Stephens-Shields A, Dalembert G, McPeak KE, Jenssen BP, Fiks AG. Trends in Positive Depression and Suicide Risk Screens in Pediatric Primary Care During COVID-19. Acad Pediatr 2023; 23:1159-1165. [PMID: 36584938 PMCID: PMC9792424 DOI: 10.1016/j.acap.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 12/08/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Adolescent mental health concerns increased during COVID-19, but it is unknown whether early increases in depression and suicide risk have been sustained. We examined changes in positive screens for depression and suicide risk in a large pediatric primary care network through May 2022. METHODS Using an observational repeated cross-sectional design, we examined changes in depression and suicide risk during the pandemic using electronic health record data from adolescents. Segmented logistic regression was used to estimate risk differences (RD) for positive depression and suicide risk screens during the early pandemic (June 2020-May 2021) and late pandemic (June 2021-May 2022) relative to before the pandemic (March 2018-February 2020). Models adjusted for seasonality and standard errors accounted for clustering by practice. RESULTS Among 222,668 visits for 115,627 adolescents (mean age 15.7, 50% female), the risk of positive depression and suicide risk screens increased during the early pandemic period relative to the prepandemic period (RD, 3.8%; 95% CI, 2.9, 4.8; RD, 2.8%; 95% CI, 1.7, 3.8). Risk of depression returned to baseline during the late pandemic period, while suicide risk remained slightly elevated (RD, 0.7%; 95% CI, -0.4, 1.7; RD, 1.8%; 95% CI, 0.9%, 2.7%). CONCLUSIONS During the early months of the pandemic, there was an increase in positive depression and suicide risk screens, which later returned to prepandemic levels for depression but not suicide risk. Results suggest that pediatricians should continue to prioritize screening adolescents for depressive symptoms and suicide risk and connect them to treatment.
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Affiliation(s)
- Chloe Hannan
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Stephanie L Mayne
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa.
| | - Mary Kate Kelly
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab, Children's Hospital of Philadelphia (M Davis and JF Young), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and AG Fiks), Philadelphia, Pa
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab, Children's Hospital of Philadelphia (M Davis and JF Young), Philadelphia, Pa; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (JF Young), Philadelphia, Pa
| | - Maura Powell
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Alisa Stephens-Shields
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania (A Stephens-Shields), Philadelphia, Pa
| | - George Dalembert
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Katie E McPeak
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Brian P Jenssen
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Alexander G Fiks
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and AG Fiks), Philadelphia, Pa
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Rea KE, Armah AE, Eaton CK, Suveg C, Davis M. "It's On Me": Perspectives of College Students Without Complex Medical Needs Learning to Manage Their Healthcare. Clin Pract Pediatr Psychol 2023; 11:217-227. [PMID: 37583937 PMCID: PMC10424779 DOI: 10.1037/cpp0000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Objective Most of the transition literature examines adolescents and young adults with special healthcare needs, though many youth will eventually transition to adult healthcare providers, regardless of medical complexity. This study addresses this gap by examining transition needs and experiences specifically within a college student sample of emerging adults without complex medical needs. Methods 108 college students (Mage=20.93 years, SD=1.14) completed interviews and questionnaires regarding transition. The most difficult and easiest aspects of healthcare self-management were thematically coded. Differences in questionnaires were assessed across sources of transition education. Results 52% of college students reported receiving education about managing healthcare from medical providers versus 95% from caregivers. Notably, 57% desired more support. Those receiving medical provider education reported higher responsibility. Students reported most difficulty managing health insurance. Results were similar across racial and ethnic groups and genders. Conclusions Gaps in transition preparation include low rates of medical provider education and support regarding health insurance. College students receiving education from medical providers reported greater healthcare responsibility. Provider-led transition education is needed for college students without complex medical needs. Implications for Impact Statement This study suggests that college students without complex medical conditions experience gaps in transition preparation. Although half reported talking to their medical provider about transition to adult care, many desired more support, with the greatest difficulty reported in learning to manage health insurance.
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Davis M, Siegel J, Becker-Haimes EM, Jager-Hyman S, Beidas RS, Young JF, Wislocki K, Futterer A, Mautone JA, Buttenheim AM, Mandell DS, Marx D. Identifying Common and Unique Barriers and Facilitators to Implementing Evidence-Based Practices for Suicide Prevention across Primary Care and Specialty Mental Health Settings. Arch Suicide Res 2023; 27:192-214. [PMID: 34651544 PMCID: PMC9930207 DOI: 10.1080/13811118.2021.1982094] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We identified common and unique barriers and facilitators of evidence-based suicide prevention practices across primary care practices with integrated behavioral health services and specialty mental health settings to identify generalizable strategies for enhancing future implementation efforts. METHOD Twenty-six clinicians and practice leaders from behavioral health (n = 2 programs) and primary care (n = 4 clinics) settings participated. Participation included a semi-structured qualitative interview on barriers and facilitators to implementing evidence-based suicide prevention practices. Within that interview, clinicians participated in a chart-stimulated recall exercise to gather additional information about decision making regarding suicide screening. Interview guides and qualitative coding were informed by leading frameworks in implementation science and behavioral science, and an integrated approach to interpreting qualitative results was used. RESULTS There were a number of similar themes associated with implementation of suicide prevention practices across settings and clinician types, such as the benefits of inter-professional collaboration and uncertainties about managing suicidality once risk was disclosed. Clinicians also highlighted barriers unique to their settings. For primary care settings, time constraints and competing demands were consistently described as barriers. For specialty mental health settings, difficulties coordinating care with schools and other providers in the community made implementation of suicide prevention practices challenging. CONCLUSION Findings can inform the development and testing of implementation strategies that are generalizable across primary care and specialty mental health settings, as well as those tailored for unique site needs, to enhance use of evidence-based suicide prevention practices in settings where individuals at risk for suicide are especially likely to present.HIGHLIGHTSWe examined barriers and facilitators to suicide prevention across health settings.Common and unique barriers and facilitators across health-care settings emerged.Findings can enhance suicide prevention implementation across health-care settings.
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Affiliation(s)
- Molly Davis
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA
| | - Jennifer Siegel
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Emily M. Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Hall Mercer Community Mental Health, University of Pennsylvania Health System
| | - Shari Jager-Hyman
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Rinad S. Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia, PA
| | - Jami F. Young
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Katherine Wislocki
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Anne Futterer
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Jennifer A. Mautone
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Alison M. Buttenheim
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - David S. Mandell
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Darby Marx
- Weill Cornell Medical College of Cornell University, New York, NY
| | - Courtney Benjamin Wolk
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Jones JD, Long EE, Hankin BL, Gallop R, Davis M, Young JF. Personalized Depression Prevention Reduces Dependent Stressors Among Adolescents: Results from a Randomized Controlled Trial. J Clin Child Adolesc Psychol 2023:1-14. [PMID: 36940144 PMCID: PMC10509329 DOI: 10.1080/15374416.2023.2188562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
OBJECTIVE Depression and stressors both increase during adolescence. The stress generation model posits that depression symptoms and associated impairment contribute to the generation of dependent stressors. Adolescent depression prevention programs have been shown to reduce the risk of depression. Recently, risk-informed personalization approaches have been adopted to enhance the efficacy of depression prevention, and preliminary evidence supports the beneficial effects of personalized prevention on depression symptoms. Given the close association between depression and stress, we examined the hypothesis that personalized depression prevention programs would reduce adolescents' experience of dependent stressors (interpersonal and non-interpersonal) over longitudinal follow-up. METHOD The present study included 204 adolescents (56% girls, 29% racial minority) who were randomized to receive either a cognitive-behavioral or an interpersonal prevention program. Youth were categorized as high or low on cognitive and interpersonal risk using a previously established risk classification system. Half of the adolescents received a prevention program that matched their risk profile (e.g., high cognitive risk randomized to cognitive-behavioral prevention); half received a mismatched program (e.g., high interpersonal risk randomized to cognitive-behavioral prevention). Exposure to dependent and independent stressors was assessed repeatedly over an 18-month follow-up period. RESULTS Matched adolescents reported fewer dependent stressors during the post-intervention follow-up period (d = .46, p = .002) and from baseline through 18-months post-intervention (d = .35, p = .02) compared to mismatched youth. As expected, there were no differences between matched and mismatched youth on the experience of independent stressors. CONCLUSIONS These findings further highlight the potential of personalized approaches to depression prevention and demonstrate benefits that go beyond depression symptom reduction.
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Affiliation(s)
- Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
| | - Erin E Long
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
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Greenberg H, Davis M. How confident are UK radiographers at performing paediatric computed tomography trauma scans? Radiography (Lond) 2023; 29:362-368. [PMID: 36758381 DOI: 10.1016/j.radi.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Approximately 45% of paediatric deaths in the United Kingdom (UK) were as a result of trauma. Computed tomography (CT) provides time efficient and accurate diagnosis, increasing chances of survival. Whilst use of CT in evaluating paediatric trauma has been invaluable it carries significant radiation risks, largely because children have greater radiation sensitivity than adults. Although national paediatric trauma workload in the UK is proportionately low, the majority of paediatric patients are conveyed to hospitals which predominantly undertake CT scans on adult patients. This research aimed to determine the confidence levels of radiographers when performing paediatric CT trauma scans in three public hospitals in the UK, and whether a teaching intervention improved their perceived self-confidence. METHODS Individual questionnaires containing eight qualitative and quantitative questions were used to ascertain radiographers' perceived confidence levels. A teaching intervention was developed based on responses. A post-intervention questionnaire was used to determine whether radiographers' confidence levels had improved. RESULTS Radiographers (n = 45) reported a mean confidence score of 5.6 (standard deviation 2.2) and 8.0 (standard deviation 1.7) scanning paediatric trauma patients pre- and post-intervention respectively. A paired two group t-test found this difference to be statistically significant at p < .00001. Radiographers reported several factors which negatively influenced confidence levels, including limited experience and postgraduate education. CONCLUSION Radiographers reported to be less confident scanning paediatric CT trauma patients compared to adults, pre- and post-intervention, however this research does not clarify whether this is as a result of an increase in competence. Further research regarding this concept warrants investigation. IMPLICATIONS FOR PRACTICE Results suggest further training based on negative factors reported by radiographers can increase confidence when performing this type of scan, assisting radiographers in optimising paediatric patient doses.
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Affiliation(s)
- H Greenberg
- Radiography and Diagnostic Imaging, School of Medicine and Medical Science, University College Dublin, Ireland.
| | - M Davis
- Radiography and Diagnostic Imaging, School of Medicine and Medical Science, University College Dublin, Ireland.
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Kasthuri V, Shamshad A, Davis M, Yoon J, Kumar S, Ahn S. Abstract No. 605 Modern Search Analytics: What Are Patients Asking about Varicocele Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Davis M, Stephens A, Morrison C, Majdalany S, Affas R, Arora S, Corsi N, Rakic I, Sood A, Rogers C, Abdollah F. Racial disparities in future development of lethal prostate cancer based on PSA levels in midlife. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01236-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Hatta M, Ruzicka J, Measures C, Davis M. Automated calibration by a single standard solution prepared in deionized water by flow programming eliminates the schlieren and salinity effects and is applied to the determination of phosphate in sea water of different salinities. Talanta 2023. [DOI: 10.1016/j.talanta.2022.124041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Davis M, Stephens A, Morrison C, Majdalany S, Affas R, Arora S, Corsi N, Rakic I, Sood A, Rogers C, Abdollah F. Baseline PSA levels in midlife & future development of lethal prostate cancer: A diverse North American cohort analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00307-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Rakic I, Davis M, Corsi N, Stephens A, Arora S, Rakic N, Morrison C, Malchow T, Affas R, Sood A, Rogers C, Abdollah F. Evaluating the role of lymphvascular invasion as an indicator for adverse outcomes for patients with upper tract urothelial carcinoma and its histological subtypes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00960-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Corsi N, Stephens A, Malchow T, Piontkowski A, Corsi M, Davis M, Arora S, Rakic I, Morrison C, Autorino R, Sood A, Rogers C, Abdollah F. Testing the external validity of the pout III trial (adjuvant platnium-based chemotherapy in upper tract urothelial carcinoma) in a North American cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Roaldsen MB, Eltoft A, Wilsgaard T, Christensen H, Engelter ST, Indredavik B, Jatužis D, Karelis G, Kõrv J, Lundström E, Petersson J, Putaala J, Søyland MH, Tveiten A, Bivard A, Johnsen SH, Mazya MV, Werring DJ, Wu TY, De Marchis GM, Robinson TG, Mathiesen EB, Valente M, Chen A, Sharobeam A, Edwards L, Blair C, Christensen L, Ægidius K, Pihl T, Fassel-Larsen C, Wassvik L, Folke M, Rosenbaum S, Gharehbagh SS, Hansen A, Preisler N, Antsov K, Mallene S, Lill M, Herodes M, Vibo R, Rakitin A, Saarinen J, Tiainen M, Tumpula O, Noppari T, Raty S, Sibolt G, Nieminen J, Niederhauser J, Haritoncenko I, Puustinen J, Haula TM, Sipilä J, Viesulaite B, Taroza S, Rastenyte D, Matijosaitis V, Vilionskis A, Masiliunas R, Ekkert A, Chmeliauskas P, Lukosaitis V, Reichenbach A, Moss TT, Nilsen HY, Hammer-Berntzen R, Nordby LM, Weiby TA, Nordengen K, Ihle-Hansen H, Stankiewiecz M, Grotle O, Nes M, Thiemann K, Særvold IM, Fraas M, Størdahl S, Horn JW, Hildrum H, Myrstad C, Tobro H, Tunvold JA, Jacobsen O, Aamodt N, Baisa H, Malmberg VN, Rohweder G, Ellekjær H, Ildstad F, Egstad E, Helleberg BH, Berg HH, Jørgensen J, Tronvik E, Shirzadi M, Solhoff R, Van Lessen R, Vatne A, Forselv K, Frøyshov H, Fjeldstad MS, Tangen L, Matapour S, Kindberg K, Johannessen C, Rist M, Mathisen I, Nyrnes T, Haavik A, Toverud G, Aakvik K, Larsson M, Ytrehus K, Ingebrigtsen S, Stokmo T, Helander C, Larsen IC, Solberg TO, Seljeseth YM, Maini S, Bersås I, Mathé J, Rooth E, Laska AC, Rudberg AS, Esbjörnsson M, Andler F, Ericsson A, Wickberg O, Karlsson JE, Redfors P, Jood K, Buchwald F, Mansson K, Gråhamn O, Sjölin K, Lindvall E, Cidh Å, Tolf A, Fasth O, Hedström B, Fladt J, Dittrich TD, Kriemler L, Hannon N, Amis E, Finlay S, Mitchell-Douglas J, McGee J, Davies R, Johnson V, Nair A, Robinson M, Greig J, Halse O, Wilding P, Mashate S, Chatterjee K, Martin M, Leason S, Roberts J, Dutta D, Ward D, Rayessa R, Clarkson E, Teo J, Ho C, Conway S, Aissa M, Papavasileiou V, Fry S, Waugh D, Britton J, Hassan A, Manning L, Khan S, Asaipillai A, Fornolles C, Tate ML, Chenna S, Anjum T, Karunatilake D, Foot J, VanPelt L, Shetty A, Wilkes G, Buck A, Jackson B, Fleming L, Carpenter M, Jackson L, Needle A, Zahoor T, Duraisami T, Northcott K, Kubie J, Bowring A, Keenan S, Mackle D, England T, Rushton B, Hedstrom A, Amlani S, Evans R, Muddegowda G, Remegoso A, Ferdinand P, Varquez R, Davis M, Elkin E, Seal R, Fawcett M, Gradwell C, Travers C, Atkinson B, Woodward S, Giraldo L, Byers J, Cheripelli B, Lee S, Marigold R, Smith S, Zhang L, Ghatala R, Sim CH, Ghani U, Yates K, Obarey S, Willmot M, Ahlquist K, Bates M, Rashed K, Board S, Andsberg G, Sundayi S, Garside M, Macleod MJ, Manoj A, Hopper O, Cederin B, Toomsoo T, Gross-Paju K, Tapiola T, Kestutis J, Amthor KF, Heermann B, Ottesen V, Melum TA, Kurz M, Parsons M, Valente M, Chen A, Sharobeam A, Edwards L, Blair C. Safety and efficacy of tenecteplase in patients with wake-up stroke assessed by non-contrast CT (TWIST): a multicentre, open-label, randomised controlled trial. Lancet Neurol 2023; 22:117-126. [PMID: 36549308 DOI: 10.1016/s1474-4422(22)00484-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Current evidence supports the use of intravenous thrombolysis with alteplase in patients with wake-up stroke selected with MRI or perfusion imaging and is recommended in clinical guidelines. However, access to advanced imaging techniques is often scarce. We aimed to determine whether thrombolytic treatment with intravenous tenecteplase given within 4·5 h of awakening improves functional outcome in patients with ischaemic wake-up stroke selected using non-contrast CT. METHODS TWIST was an investigator-initiated, multicentre, open-label, randomised controlled trial with blinded endpoint assessment, conducted at 77 hospitals in ten countries. We included patients aged 18 years or older with acute ischaemic stroke symptoms upon awakening, limb weakness, a National Institutes of Health Stroke Scale (NIHSS) score of 3 or higher or aphasia, a non-contrast CT examination of the head, and the ability to receive tenecteplase within 4·5 h of awakening. Patients were randomly assigned (1:1) to either a single intravenous bolus of tenecteplase 0·25 mg per kg of bodyweight (maximum 25 mg) or control (no thrombolysis) using a central, web-based, computer-generated randomisation schedule. Trained research personnel, who conducted telephone interviews at 90 days (follow-up), were masked to treatment allocation. Clinical assessments were performed on day 1 (at baseline) and day 7 of hospital admission (or at discharge, whichever occurred first). The primary outcome was functional outcome assessed by the modified Rankin Scale (mRS) at 90 days and analysed using ordinal logistic regression in the intention-to-treat population. This trial is registered with EudraCT (2014-000096-80), ClinicalTrials.gov (NCT03181360), and ISRCTN (10601890). FINDINGS From June 12, 2017, to Sept 30, 2021, 578 of the required 600 patients were enrolled (288 randomly assigned to the tenecteplase group and 290 to the control group [intention-to-treat population]). The median age of participants was 73·7 years (IQR 65·9-81·1). 332 (57%) of 578 participants were male and 246 (43%) were female. Treatment with tenecteplase was not associated with better functional outcome, according to mRS score at 90 days (adjusted OR 1·18, 95% CI 0·88-1·58; p=0·27). Mortality at 90 days did not significantly differ between treatment groups (28 [10%] patients in the tenecteplase group and 23 [8%] in the control group; adjusted HR 1·29, 95% CI 0·74-2·26; p=0·37). Symptomatic intracranial haemorrhage occurred in six (2%) patients in the tenecteplase group versus three (1%) in the control group (adjusted OR 2·17, 95% CI 0·53-8·87; p=0·28), whereas any intracranial haemorrhage occurred in 33 (11%) versus 30 (10%) patients (adjusted OR 1·14, 0·67-1·94; p=0·64). INTERPRETATION In patients with wake-up stroke selected with non-contrast CT, treatment with tenecteplase was not associated with better functional outcome at 90 days. The number of symptomatic haemorrhages and any intracranial haemorrhages in both treatment groups was similar to findings from previous trials of wake-up stroke patients selected using advanced imaging. Current evidence does not support treatment with tenecteplase in patients selected with non-contrast CT. FUNDING Norwegian Clinical Research Therapy in the Specialist Health Services Programme, the Swiss Heart Foundation, the British Heart Foundation, and the Norwegian National Association for Public Health.
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Affiliation(s)
- Melinda B Roaldsen
- Department of Clinical Research, University Hospital of North Norway, Tromsø, Norway
| | - Agnethe Eltoft
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Hanne Christensen
- Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Stefan T Engelter
- Department of Neurology, University Hospital Basel, Basel, Switzerland; Department of Neurology and Neurorehabilitation, University of Basel, Basel, Switzerland; University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Bent Indredavik
- Department of Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway; Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dalius Jatužis
- Faculty of Medicine, Vilnius University, Center of Neurology, Vilnius, Lithuania
| | - Guntis Karelis
- Department of Neurology and Neurosurgery, Riga East University Hospital, Riga, Latvia; Rīga Stradiņš University, Riga, Latvia
| | - Janika Kõrv
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Erik Lundström
- Department of Medicine and Neurology, Uppsala University, Uppsala, Sweden
| | - Jesper Petersson
- Department of Neurology, Lund University, Institute for Clinical Sciences Lund, Lund, Sweden
| | - Jukka Putaala
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mary-Helen Søyland
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurology, Hospital of Southern Norway, Kristiansand, Norway
| | - Arnstein Tveiten
- Department of Neurology, Hospital of Southern Norway, Kristiansand, Norway
| | - Andrew Bivard
- Department of Medicine, Royal Melbourne Hospital, Melbourne Brain Centre, Melbourne, VIC, Australia
| | - Stein Harald Johnsen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Michael V Mazya
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - David J Werring
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Teddy Y Wu
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - Gian Marco De Marchis
- Department of Neurology, University Hospital Basel, Basel, Switzerland; Department of Neurology, University of Basel, Basel, Switzerland
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Ellisiv B Mathiesen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
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Pandolfo S, Wu Z, Giuseppe S, Ferro M, Sundaram C, Yong C, Derweesh I, Dhanji S, Margulis V, Taylor J, Tozzi M, Davis M, Wood E, Mehrazin R, Gonzalgo M, Eilender B, Mendiola D, Wang L, Tuderti G, Checcucci E, Verze P, Djaladat H, Porpiglia F, Abdollah F, Autorino R. Predictive factors of complications in patients undergoing minimally invasive radical nephroureterectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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22
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Kanine RM, Bush ML, Davis M, Jones JD, Sbrilli MD, Young JF. Depression Prevention in Pediatric Primary Care: Implementation and Outcomes of Interpersonal Psychotherapy-Adolescent Skills Training. Child Psychiatry Hum Dev 2023; 54:96-108. [PMID: 34379228 DOI: 10.1007/s10578-021-01222-6] [Citation(s) in RCA: 4] [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] [Accepted: 07/25/2021] [Indexed: 01/27/2023]
Abstract
This study evaluated the fidelity, feasibility, acceptability, and preliminary outcomes of a depression prevention program, interpersonal psychotherapy-adolescent skills training (IPT-AST), in urban pediatric primary care (PC) with a sample of primarily Black youth. Twenty-two adolescents with elevated depressive symptoms participated in this open clinical trial. Adolescents were identified through a screening questionnaire completed at well visits. Ratings of IPT-AST fidelity and session attendance were recorded. Youth and caregivers reported on their attitudes toward the intervention and completed measures of adolescents' symptoms and functioning pre- and post-intervention. Results demonstrated high levels of fidelity, attendance, and acceptability, despite some difficulties with recruitment. Adolescents and caregivers reported significant improvements in functioning. There were marginally significant reductions in self-reported depression, anxiety, and total mental health symptoms. Caregivers reported a significant decrease in total mental health symptoms. Findings provide preliminary information regarding the implementation and effects of IPT-AST when delivered in PC.
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Affiliation(s)
- Rebecca M Kanine
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South St., Room 8472, Philadelphia, PA, 19146, USA.
| | - Morgan L Bush
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South St., Room 8472, Philadelphia, PA, 19146, USA
| | - Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South St., Room 8472, Philadelphia, PA, 19146, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marissa D Sbrilli
- Clinical-Community Psychology PhD Program, Department of Psychology, University of Illinois - Urbana Champaign, Champaign, IL, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South St., Room 8472, Philadelphia, PA, 19146, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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23
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Tregidgo L, Hammond R, Bramley A, Davis M, Morshed A, Patel A, Pradhan A, D'Cruz R, Lipman M. Delayed-onset disseminated BCG disease causing a multi-system illness with fatal mycotic aortic aneurysm. Clinical Infection in Practice 2022. [DOI: 10.1016/j.clinpr.2022.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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24
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Cushman GK, West KB, Davis M, LaMotte J, Eaton CK, Gutierrez-Colina AM, Suveg C, Blount RL. The role of executive functioning, healthcare management, and self-efficacy in college students' health-related quality of life. J Am Coll Health 2022; 70:2356-2364. [PMID: 33400895 PMCID: PMC8255329 DOI: 10.1080/07448481.2020.1862128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 09/14/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
Objective: Examine how executive functioning (EF), healthcare management, and self-efficacy relate to college students' health-related quality of life (HRQOL). Participants: Undergraduates completed questionnaires at baseline (Time 1; n = 387) and 18-24 months later (Time 2; n = 102). Methods: Participants reported on their EF and healthcare management skills at Time 1 and self-efficacy and mental and physical HRQOL at Time 2. Results: Students with fewer EF problems reported higher mental and physical HRQOL at both timepoints and those with higher healthcare management skills had higher mental and physical HRQOL at Time 1. Higher self-efficacy mediated the relation between EF and mental HRQOL, and the relation between healthcare management and mental HRQOL. Conclusions: Findings illustrate two potential pathways by which self-management, in healthcare settings or daily living, contributes to mental HRQOL during emerging adulthood. Assessing EF and healthcare management could help identify those at risk of low HRQOL and provide information that can inform interventions in college settings.
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Affiliation(s)
| | - Kara B West
- The University of Georgia, Athens, Georgia, USA
| | - Molly Davis
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Julia LaMotte
- Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, Pennsylvania, USA
| | - Cyd K Eaton
- Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, Maryland, USA
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25
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Saunders J, Smith L, Daniels I, Edwards T, Hanson E, Gaston B, Davis M. 550 Safe inhaled alkaline medication that alters airway pH in cystic fibrosis and inhibits respiratory syncytial virus infection. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01240-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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26
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Davis M, Starovoytov A, Campbell C, Hawkins N, Virani S, Luong M, Straatman L, Kiess M, Worsley D, Sathananthan J, Fine N. DEVELOPMENT OF A DIAGNOSTIC SCREENING ALGORITHM FOR THE IDENTIFICATION OF TRANSTHYRETIN AMYLOID CARDIOMYOPATHY IN HIGH-RISK PATIENT POPULATIONS. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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27
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Dhillon S, Buttar J, Davis M, Marwaha A. PREVALENCE OF ANEMIA IN CARDIAC AMYLOIDOSIS AND ASSOCIATION WITH CLINICAL FACTORS AND OUTCOMES. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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28
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Rudd BN, Davis M, Doupnik S, Ordorica C, Marcus SC, Beidas RS. Implementation Strategies Used and Reported in Brief Suicide Prevention Intervention Studies. JAMA Psychiatry 2022; 79:829-831. [PMID: 35704303 PMCID: PMC9201740 DOI: 10.1001/jamapsychiatry.2022.1462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/24/2022] [Indexed: 11/14/2022]
Affiliation(s)
- Brittany N. Rudd
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Implementation Science Center at the Leonard Davis Institute, University of Pennsylvania, Philadelphia
| | - Molly Davis
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Implementation Science Center at the Leonard Davis Institute, University of Pennsylvania, Philadelphia
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia
| | - Stephanie Doupnik
- Penn Implementation Science Center at the Leonard Davis Institute, University of Pennsylvania, Philadelphia
- Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Catalina Ordorica
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago
| | - Steven C. Marcus
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Implementation Science Center at the Leonard Davis Institute, University of Pennsylvania, Philadelphia
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia
| | - Rinad S. Beidas
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Implementation Science Center at the Leonard Davis Institute, University of Pennsylvania, Philadelphia
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia
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29
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Meyer CH, Grant A, Sola R, Gills K, Mora AN, Tracy BM, Muralidharan VJ, Koganti D, Todd SR, Butler C, Nguyen J, Hurst S, Udobi K, Sciarretta J, Williams K, Davis M, Dente C, Benjamin E, Ayoung-Chee P, Smith RN. Presentation, clinical course and complications in trauma patients with concomitant COVID-19 infection. Am J Surg 2022; 224:607-611. [PMID: 35534294 PMCID: PMC8978444 DOI: 10.1016/j.amjsurg.2022.03.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/20/2022] [Accepted: 03/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigated the impact of COVID-19 infection on hospitalized trauma patients. METHODS A retrospective review of hospitalized trauma patients at a level I trauma center was performed from March-December 2020. Data pertaining to patient demographics, presentation and hospital course was compared between COVID positive and negative trauma patients. RESULTS There were 4,912 patients and 179 (3.64%) were COVID-19 positive. Demographics and clinical presentation did not differ significantly between those with and without concomitant COVID-19. However, COVID positive trauma patients had higher rates of acute kidney injury (p = 0.016), sepsis (p = 0.016), unplanned intubation (p = 0.002) and unplanned return to the ICU (p = 0.01). The COVID positive cohort also had longer hospital stays (p < 0.01) with no significant difference in mortality. CONCLUSIONS In the setting of an ongoing pandemic, awareness of the complications COVID positive trauma patients are predisposed to is important for providers.
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Affiliation(s)
- C H Meyer
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - A Grant
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - Richard Sola
- Grady Health System, Atlanta, GA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
| | - K Gills
- Grady Health System, Atlanta, GA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
| | - Ariana N Mora
- Emory University School of Medicine, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - B M Tracy
- The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | | | - D Koganti
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - S R Todd
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - C Butler
- Grady Health System, Atlanta, GA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
| | - J Nguyen
- Grady Health System, Atlanta, GA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
| | - S Hurst
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - K Udobi
- Grady Health System, Atlanta, GA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
| | - J Sciarretta
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - K Williams
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - M Davis
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - C Dente
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - E Benjamin
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
| | - P Ayoung-Chee
- Grady Health System, Atlanta, GA, USA; Morehouse School of Medicine, Atlanta, GA, USA.
| | - R N Smith
- Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Davis M, Hoskins K, Phan M, Hoffacker C, Reilly M, Fugo PB, Young JF, Beidas RS. Screening Adolescents for Sensitive Health Topics in Primary Care: A Scoping Review. J Adolesc Health 2022; 70:706-713. [PMID: 34955356 PMCID: PMC9038619 DOI: 10.1016/j.jadohealth.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 06/30/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 11/15/2022]
Abstract
We sought to aggregate common barriers and facilitators to screening adolescents for sensitive health topics (e.g., depression, chlamydia) in primary care, as well as those that are unique to a given health topic. We conducted a literature search of three databases (PsycInfo, MEDLINE, and CINAHL) and reference lists of included articles. Studies focused on barriers and facilitators to screening adolescents (ages 12-17 years) for sensitive health topics in primary care that are recommended by national guidelines. Articles were peer-reviewed, presented empirical data, and were published in English in 2006-2021. We coded barriers and facilitators using the Consolidated Framework for Implementation Research, a well-established framework within implementation science. In total, 39 studies met inclusion criteria and spanned several health topics: depression, suicide, substance use, HIV, and chlamydia. We found common barriers and facilitators to screening across health topics, with most relating to characteristics of the primary care clinics (e.g., time constraints). Other factors relevant to screening implementation ranged from confidentiality concerns to clinician knowledge. Barriers and facilitators specific to certain health topics, such as the availability of on-site laboratories for HIV screening, were also noted. Findings can guide refinements to screening implementation.
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Affiliation(s)
- Molly Davis
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Katelin Hoskins
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA;,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary Phan
- Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, Utah, USA
| | - Carlin Hoffacker
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Megan Reilly
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Perrin B. Fugo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jami F. Young
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA;,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, USA and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Rinad S. Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA;,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, Pennsylvania, USA;,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA;,Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;,Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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31
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Gutierrez-Colina AM, Davis M, Eaton CK, LaMotte J, Cushman G, Quast L, Blount RL, Suveg C. The role of executive functioning in health self-management and the transition to adult health care among college students. J Am Coll Health 2022; 70:830-836. [PMID: 32610030 PMCID: PMC7908933 DOI: 10.1080/07448481.2020.1775605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 04/13/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveTo examine the role of executive functioning (EF) in health self-management and the transition to adult health care among college students. Participants: A total of 378 undergraduate students from a public university participated in the study. Methods: Participants reported on EF, health self-management skills, and their readiness to transition to adult care. Mediation analyses were conducted to evaluate indirect effects of EF on readiness to transition via health self-management skills. Results: Students with greater EF difficulties were less ready to transition to adult care. Specific aspects of health self-management (Medication management/Appointment keeping) mediated the relationship between EF and readiness to transition. Conclusion: EF is a key developmental aspect of health self-management and transition readiness. Assessing EF strengths/weaknesses in students with suboptimal health self-management skills may provide valuable information for informing the development of individually-tailored transition plans in university health centers, thereby enhancing developmentally appropriate care during the college years.
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Affiliation(s)
| | - Molly Davis
- The University of Georgia, 125 Baldwin St., Athens, GA 30602
| | - Cyd K. Eaton
- The University of Georgia, 125 Baldwin St., Athens, GA 30602
| | - Julia LaMotte
- The University of Georgia, 125 Baldwin St., Athens, GA 30602
| | - Grace Cushman
- The University of Georgia, 125 Baldwin St., Athens, GA 30602
| | - Lauren Quast
- The University of Georgia, 125 Baldwin St., Athens, GA 30602
| | | | - Cynthia Suveg
- The University of Georgia, 125 Baldwin St., Athens, GA 30602
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32
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Gentleman AS, Lawson T, Ellis MG, Davis M, Turner-Dore J, Ryder ASH, Frosz MH, Ciaccia M, Reisner E, Cresswell AJ, Euser TG. Stern–Volmer analysis of photocatalyst fluorescence quenching within hollow-core photonic crystal fibre microreactors. Chem Commun (Camb) 2022; 58:10548-10551. [DOI: 10.1039/d2cc03996f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Optofluidic microreactors enable Stern–Volmer analysis on nanolitre-scale photocatalyst–quencher mixtures. The method is used to measure bimolecular quenching coefficients for a photoredox-catalysed α-C–H alkylation reaction of primary alkylamines.
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Affiliation(s)
- Alexander S. Gentleman
- Nanophotonics Centre, The Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
- Yusuf Hamied Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Takashi Lawson
- Nanophotonics Centre, The Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
- Yusuf Hamied Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Matthew G. Ellis
- Nanophotonics Centre, The Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
| | - Molly Davis
- Nanophotonics Centre, The Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
| | - Jacob Turner-Dore
- Department of Chemistry, University of Bath, 1 South, Claverton Down, Bath, BA2 7AY, UK
| | - Alison S. H. Ryder
- Department of Chemistry, University of Bath, 1 South, Claverton Down, Bath, BA2 7AY, UK
| | - Michael H. Frosz
- Max Planck Institute for the Science of Light, Staudtstr. 2, 91058, Erlangen, Germany
| | - Maria Ciaccia
- Syngenta, Jealott's Hill Research Centre, Bracknell, Berkshire, RG52 6EY, UK
| | - Erwin Reisner
- Yusuf Hamied Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | | | - Tijmen G. Euser
- Nanophotonics Centre, The Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge, CB3 0HE, UK
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33
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Dofash L, Faiz F, Servián-Morilla E, Rivas E, Sullivan P, Oates E, Clayton J, Taylor R, Davis M, Laing N, Cabrera-Serrano M, Ravenscroft G. CONGENITAL MYOPATHIES – NEMALINE MYOPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Beidas RS, Ahmedani BK, Linn KA, Marcus SC, Johnson C, Maye M, Westphal J, Wright L, Beck AL, Buttenheim AM, Daley MF, Davis M, Elias ME, Jager-Hyman S, Hoskins K, Lieberman A, McArdle B, Ritzwoller DP, Small DS, Wolk CB, Williams NJ, Boggs JM. Study protocol for a type III hybrid effectiveness-implementation trial of strategies to implement firearm safety promotion as a universal suicide prevention strategy in pediatric primary care. Implement Sci 2021; 16:89. [PMID: 34551811 PMCID: PMC8456701 DOI: 10.1186/s13012-021-01154-8] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/24/2021] [Indexed: 01/23/2023] Open
Abstract
Background Insights from behavioral economics, or how individuals’ decisions and behaviors are shaped by finite cognitive resources (e.g., time, attention) and mental heuristics, have been underutilized in efforts to increase the use of evidence-based practices in implementation science. Using the example of firearm safety promotion in pediatric primary care, which addresses an evidence-to-practice gap in universal suicide prevention, we aim to determine: is a less costly and more scalable behavioral economic-informed implementation strategy (i.e., “Nudge”) powerful enough to change clinician behavior or is a more intensive and expensive facilitation strategy needed to overcome implementation barriers? Methods The Adolescent and child Suicide Prevention in Routine clinical Encounters (ASPIRE) hybrid type III effectiveness-implementation trial uses a longitudinal cluster randomized design. We will test the comparative effectiveness of two implementation strategies to support clinicians’ use of an evidence-based firearm safety practice, S.A.F.E. Firearm, in 32 pediatric practices across two health systems. All pediatric practices in the two health systems will receive S.A.F.E. Firearm materials, including training and cable locks. Half of the practices (k = 16) will be randomized to receive Nudge; the other half (k = 16) will be randomized to receive Nudge plus 1 year of facilitation to target additional practice and clinician implementation barriers (Nudge+). The primary implementation outcome is parent-reported clinician fidelity to the S.A.F.E Firearm program. Secondary implementation outcomes include reach and cost. To understand how the implementation strategies work, the primary mechanism to be tested is practice adaptive reserve, a self-report practice-level measure that includes relationship infrastructure, facilitative leadership, sense-making, teamwork, work environment, and culture of learning. Discussion The ASPIRE trial will integrate implementation science and behavioral economic approaches to advance our understanding of methods for implementing evidence-based firearm safety promotion practices in pediatric primary care. The study answers a question at the heart of many practice change efforts: which strategies are sufficient to support change, and why? Results of the trial will offer valuable insights into how best to implement evidence-based practices that address sensitive health matters in pediatric primary care. Trial registration ClinicalTrials.gov, NCT04844021. Registered 14 April 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-021-01154-8.
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Affiliation(s)
- Rinad S Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Brian K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Kristin A Linn
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven C Marcus
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Christina Johnson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Melissa Maye
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Joslyn Westphal
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Leslie Wright
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | - Arne L Beck
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | | | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | - Molly Davis
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marisa E Elias
- Department of Pediatrics, Henry Ford Health System, Detroit, MI, USA
| | - Shari Jager-Hyman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katelin Hoskins
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Adina Lieberman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bridget McArdle
- Department of Pediatrics, Henry Ford Health System, Detroit, MI, USA
| | - Debra P Ritzwoller
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | - Dylan S Small
- Wharton School of Business, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jennifer M Boggs
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
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Mayne SL, Hannan C, Davis M, Young JF, Kelly MK, Powell M, Dalembert G, McPeak KE, Jenssen BP, Fiks AG. COVID-19 and Adolescent Depression and Suicide Risk Screening Outcomes. Pediatrics 2021; 148:peds.2021-051507. [PMID: 34140393 DOI: 10.1542/peds.2021-051507] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [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] [Accepted: 06/07/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mental health concerns increased during the coronavirus disease 2019 pandemic, but previous studies have not examined depression screening in pediatric primary care. We aimed to describe changes in screening, depressive symptoms, and suicide risk among adolescents during the coronavirus disease 2019 pandemic. METHODS In a repeat cross-sectional analysis of electronic health record data from a large pediatric primary care network, we compared the percentage of primary care visits where adolescents aged 12 to 21 were screened for depression, screened positive for depressive symptoms, or screened positive for suicide risk between June and December 2019 (prepandemic) and June and December 2020 (pandemic). Changes were examined overall, by month, and by sex, race and ethnicity, insurance type, and income. Modified Poisson regression was used to calculate prevalence ratios (PRs) for the prepandemic to pandemic changes. RESULTS Depression screening at primary care visits declined from 77.6% to 75.8% during the pandemic period (PR: 0.98, 95% confidence interval [CI]: 0.90-1.06). The percentage of adolescents screening positive for depressive symptoms increased from 5.0% to 6.2% (PR: 1.24, 95% CI: 1.15-1.34), with greater increases among female, non-Hispanic Black, and non-Hispanic white adolescents. Positive suicide risk screens increased from 6.1% to 7.1% (PR: 1.16, 95% CI: 1.08-1.26), with a 34% relative increase in reporting recent suicidal thoughts among female adolescents (PR: 1.34, 95% CI: 1.18-1.52). CONCLUSIONS Results suggest that depression and suicide concerns have increased during the pandemic, especially among female adolescents. Results underscore the importance of consistent depression and suicidality screening.
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Affiliation(s)
- Stephanie L Mayne
- The Possibilities Project, Children's Hospital of Philadelphia .,Departments of Pediatrics.,Center for Pediatric Clinical Effectiveness and PolicyLab
| | - Chloe Hannan
- The Possibilities Project, Children's Hospital of Philadelphia.,Center for Pediatric Clinical Effectiveness and PolicyLab
| | - Molly Davis
- Psychiatry, Perelman School of Medicine.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jami F Young
- Center for Pediatric Clinical Effectiveness and PolicyLab.,Psychiatry, Perelman School of Medicine.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Mary Kate Kelly
- The Possibilities Project, Children's Hospital of Philadelphia.,Center for Pediatric Clinical Effectiveness and PolicyLab
| | - Maura Powell
- The Possibilities Project, Children's Hospital of Philadelphia
| | - George Dalembert
- The Possibilities Project, Children's Hospital of Philadelphia.,Departments of Pediatrics.,Center for Pediatric Clinical Effectiveness and PolicyLab
| | - Katie E McPeak
- The Possibilities Project, Children's Hospital of Philadelphia.,Departments of Pediatrics.,Center for Pediatric Clinical Effectiveness and PolicyLab
| | - Brian P Jenssen
- The Possibilities Project, Children's Hospital of Philadelphia.,Departments of Pediatrics.,Center for Pediatric Clinical Effectiveness and PolicyLab
| | - Alexander G Fiks
- The Possibilities Project, Children's Hospital of Philadelphia.,Departments of Pediatrics.,Center for Pediatric Clinical Effectiveness and PolicyLab
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Tabernero J, Bendell J, Corcoran R, Kopetz S, Lee J, Davis M, Christensen J, Chi A, Kheoh T, Yaeger R. P-71 KRYSTAL-10: A randomized phase 3 study of adagrasib (MRTX849) in combination with cetuximab vs chemotherapy in patients with previously treated advanced colorectal cancer with KRASG12C mutation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.126] [Citation(s) in RCA: 1] [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: 10/20/2022] Open
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Davis M, Beidas RS. Refining contextual inquiry to maximize generalizability and accelerate the implementation process. Implementation Research and Practice 2021; 2:2633489521994941. [PMID: 37089986 PMCID: PMC9978671 DOI: 10.1177/2633489521994941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: While contextual inquiry, or in-depth mixed-methods work to study the implementation context, is critical for understanding the setting in which a behavioral health evidence-based practice (EBP) will be implemented, current methods to determine potential barriers and facilitators to implementation are often conducted in a single setting and/or for a single EBP per study, often taking 1–2 years to complete. To maximize generalizability and reduce the research-to-practice gap efficiently, it is important to move toward cross-sector and/or cross-EBP contextual inquiry. Methods: In this viewpoint, we argue for (a) collaborative research studies that seek to identify determinants of implementation that are similar and unique across different settings and EBPs, using rapid approaches when possible; (b) enhanced synthesis of existing research on implementation determinants to minimize duplication of contextual inquiry efforts; and (c) clear rationale for why additional in-depth or rapid contextual inquiry is needed before it is conducted. Throughout this viewpoint, the need to balance scientific rigor and speed are considered. Conclusions: Overall, this viewpoint seeks to encourage researchers to consolidate and share knowledge on barriers and facilitators to implementation to prepare for the scaling out of much needed implementation strategies and interventions for improving health. Plain language summary: Significant time and resources are often devoted to understanding what makes it easier or harder to use best practices for behavioral health concerns in health care settings. The goal of the current viewpoint is to offer ways to streamline this process so that high-quality behavioral health services can reach the patients that need them more quickly. In particular, we advocate for ways to share knowledge among researchers and learn from prior findings to more efficiently identify what makes it easier or harder to use best practices for addressing behavioral health problems in a given setting (e.g., primary care, schools, specialty mental health).
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Affiliation(s)
- Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA
| | - Rinad S Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Best S, Hess J, Souza-Fonseca Guimaraes F, Cursons J, Kersbergen A, You Y, Ng J, Davis M, Leong T, Irving L, Ritchie M, Steinfort D, Huntington N, Sutherland K. FP10.02 Investigating the Immunophenotype of Small Cell Lung Cancer to Improve Immunotherapeutic Targeting. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Meecham L, Jacomelli J, Davis M, Pherwani A, Lees T, Earnshaw J. Outcomes in Men From the NHS Abdominal Aortic Aneurysm Screening Programme With a Large Aneurysm Referred for Intervention. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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40
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Davis M, Rubin R. 007 Prepubertal Masturbation Techniques Inflicting Penile Trauma and Erectile Dysfunction in Healthy Adult Males: A Call for Prevention and Early Education. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Davis M, Rio V, Farley AM, Bush ML, Beidas RS, Young JF. Identifying Adolescent Suicide Risk via Depression Screening in Pediatric Primary Care: An Electronic Health Record Review. Psychiatr Serv 2021; 72:163-168. [PMID: 33334159 PMCID: PMC7890460 DOI: 10.1176/appi.ps.202000207] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 11/30/2022]
Abstract
OBJECTIVE The authors evaluated suicide risk rates detected via a depression screener administered within a large pediatric primary care system and examined 1-year follow-up care after adolescents' endorsement of suicide risk. METHODS Retrospective electronic health record data were extracted to examine both suicide risk rates from items endorsed on the Patient Health Questionnaire-Modified for Teens (PHQ-9-M) and primary care providers' (PCPs') follow-up suicide risk assessments on the day of depression screening among adolescents ages 12-18 years during the period of September 1, 2014, to August 31, 2016. Manual chart review was conducted, and charts were coded for several follow-up care actions (e.g., referral to behavioral health providers and provision of crisis line information) in the year after suicidality endorsement. RESULTS In a sample of 12,690 adolescents, 5.1% endorsed thoughts of death or self-harm, 3.6% reported a lifetime suicide attempt, and 2.4% endorsed serious suicidal ideation within the past month. Manual chart review of a stratified random subsample of 150 of the 643 adolescents who endorsed a lifetime suicide attempt, serious ideation in the past month, or both illustrated the types of follow-up care they received. The PCPs adhered to the system's suicide assessment questions with high fidelity. Follow-up care from PCPs and other providers during the year after suicide risk endorsement was more variable. CONCLUSIONS Findings demonstrate the feasibility of incorporating suicide assessment procedures into depression screening in pediatric primary care and highlight avenues for maximizing preventive care for adolescents at increased risk for suicide.
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Affiliation(s)
- Molly Davis
- Department of Psychiatry (Davis, Beidas, Young) and Department of Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, and Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (Davis, Beidas), University of Pennsylvania, Philadelphia; Department of Child and Adolescent Psychiatry and Behavioral Sciences, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Rio, Bush, Young); Center for Anxiety and Related Disorders, Boston University, Boston (Farley)
| | - Victoria Rio
- Department of Psychiatry (Davis, Beidas, Young) and Department of Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, and Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (Davis, Beidas), University of Pennsylvania, Philadelphia; Department of Child and Adolescent Psychiatry and Behavioral Sciences, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Rio, Bush, Young); Center for Anxiety and Related Disorders, Boston University, Boston (Farley)
| | - Alyssa M Farley
- Department of Psychiatry (Davis, Beidas, Young) and Department of Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, and Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (Davis, Beidas), University of Pennsylvania, Philadelphia; Department of Child and Adolescent Psychiatry and Behavioral Sciences, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Rio, Bush, Young); Center for Anxiety and Related Disorders, Boston University, Boston (Farley)
| | - Morgan L Bush
- Department of Psychiatry (Davis, Beidas, Young) and Department of Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, and Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (Davis, Beidas), University of Pennsylvania, Philadelphia; Department of Child and Adolescent Psychiatry and Behavioral Sciences, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Rio, Bush, Young); Center for Anxiety and Related Disorders, Boston University, Boston (Farley)
| | - Rinad S Beidas
- Department of Psychiatry (Davis, Beidas, Young) and Department of Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, and Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (Davis, Beidas), University of Pennsylvania, Philadelphia; Department of Child and Adolescent Psychiatry and Behavioral Sciences, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Rio, Bush, Young); Center for Anxiety and Related Disorders, Boston University, Boston (Farley)
| | - Jami F Young
- Department of Psychiatry (Davis, Beidas, Young) and Department of Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, and Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (Davis, Beidas), University of Pennsylvania, Philadelphia; Department of Child and Adolescent Psychiatry and Behavioral Sciences, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Rio, Bush, Young); Center for Anxiety and Related Disorders, Boston University, Boston (Farley)
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Sutton E, Lane JA, Davis M, Walsh EI, Neal DE, Hamdy FC, Mason M, Staffurth J, Martin RM, Metcalfe C, Peters TJ, Donovan JL, Wade J. Men's experiences of radiotherapy treatment for localized prostate cancer and its long-term treatment side effects: a longitudinal qualitative study. Cancer Causes Control 2021; 32:261-269. [PMID: 33394204 PMCID: PMC7870600 DOI: 10.1007/s10552-020-01380-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/04/2020] [Indexed: 11/25/2022]
Abstract
Purpose To investigate men’s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. Methods A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. Conclusions These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT. Supplementary Information The online version of this article (10.1007/s10552-020-01380-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E. Sutton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - J. A. Lane
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, Canynge Hall, 39 Whatley Road, Clifton, Bristol, BS8 2PS UK
| | - M. Davis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - E. I. Walsh
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - D. E. Neal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - F. C. Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - M. Mason
- Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - J. Staffurth
- Department of Oncology, Cardiff University, Cardiff, UK
| | - R. M. Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - C. Metcalfe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - T. J. Peters
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - J. L. Donovan
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Trust, Bristol, UK
| | - J. Wade
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
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Davis M, Johnson C, Pettit AR, Barkin S, Hoffman BD, Jager-Hyman S, King CA, Lieberman A, Massey L, Rivara FP, Sigel E, Walton M, Benjamin Wolk C, Beidas RS. Adapting Safety Check as a Universal Suicide Prevention Strategy in Pediatric Primary Care. Acad Pediatr 2021; 21:1161-1170. [PMID: 33901726 PMCID: PMC8429196 DOI: 10.1016/j.acap.2021.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/23/2020] [Revised: 03/19/2021] [Accepted: 04/18/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The presence of unlocked firearms in the home is associated with increased risk of suicide and unintentional injury in youth. We adapted an evidence-based program for promoting safe firearm storage, Safety Check, to enhance its acceptability as a universal suicide prevention strategy in pediatric primary care. METHODS We applied ADAPT-ITT, an established adaptation framework, to guide iterative program adaptation with ongoing input from key stakeholders. The present study describes 2 phases of ADAPT-ITT: the Production phase (generating adaptations) and the Topical Experts phase (gathering stakeholder feedback on adaptations). After generating proposed program adaptations based on 3 inputs (stakeholder feedback collected in a prior study, the behavioral science literature, and best practices in pediatric medicine), we elicited feedback from stakeholders with firearm expertise. The adaptations included changes such as clarifying firearm ownership will not be documented in the medical record and offering follow-up reminders. We also crowdsourced feedback from 337 parents to select a new name and program logo. RESULTS Saturation was reached with 9 stakeholders. Feedback confirmed the value of adaptations that: 1) considered context (eg, reason for ownership), 2) promoted parent autonomy in decision-making, and 3) ensured privacy. The most preferred program name was Suicide and Accident prevention through Family Education (SAFE) Firearm. CONCLUSIONS Guided by an established adaptation framework that prioritized multistage stakeholder feedback, adaptations to the original Safety Check were deemed acceptable. We plan to test the SAFE Firearm program as a universal suicide prevention strategy in pediatric primary care via a hybrid effectiveness-implementation trial.
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Affiliation(s)
- Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (M Davis, C Johnson, S Jager-Hyman, A Lieberman, CB Wolk, and RS Beidas), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and RS Beidas), Philadelphia, Pa.
| | - Christina Johnson
- Department of Psychiatry, Perelman School of Medicine,
University of Pennsylvania, 3535, Market Street, Philadelphia, PA 19104, USA
| | - Amy R. Pettit
- Independent Consultant, PO Box 15066, Boston, MA 02215,
USA
| | - Shari Barkin
- Department of Pediatrics, Vanderbilt University Medical
Center, 2200 Children’s Way, Nashville, TN 37232, USA
| | - Benjamin D. Hoffman
- Department of Pediatrics, School of Medicine, and
Doernbecher Children’s Hospital, Oregon Health and Science University, 707 SW
Gaines St CDRCP, Portland, OR 97239, USA,Tom Sargent Children’s Safety Center, Doernbecher
Children’s Hospital, Oregon Health and Science University, Portland, OR
97239, USA
| | - Shari Jager-Hyman
- Department of Psychiatry, Perelman School of Medicine,
University of Pennsylvania, 3535, Market Street, Philadelphia, PA 19104, USA
| | - Cheryl A. King
- Department of Psychiatry, Michigan Medicine, University of
Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Adina Lieberman
- Department of Psychiatry, Perelman School of Medicine,
University of Pennsylvania, 3535, Market Street, Philadelphia, PA 19104, USA
| | - Lynn Massey
- Department of Emergency Medicine, Michigan Medicine,
University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Frederick P. Rivara
- Department of Pediatrics, University of Washington, 6200 NE
74th Street, Seattle, WA 98115, USA
| | - Eric Sigel
- Department of Pediatrics, University of Colorado School of
Medicine, 860 N Potomac Circle, Aurora, CO 80011, USA
| | - Maureen Walton
- Department of Psychiatry, Michigan Medicine, University of
Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Courtney Benjamin Wolk
- Department of Psychiatry, Perelman School of Medicine,
University of Pennsylvania, 3535, Market Street, Philadelphia, PA 19104, USA,Leonard Davis Institute of Health Economics, University of
Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA 19104, USA
| | - Rinad S. Beidas
- Department of Psychiatry, Perelman School of Medicine,
University of Pennsylvania, 3535, Market Street, Philadelphia, PA 19104, USA,Penn Implementation Science Center at the Leonard Davis
Institute of Health Economics (PISCE@LDI), University of Pennsylvania, 3641 Locust
Walk #210, Philadelphia, PA 19104, USA,Leonard Davis Institute of Health Economics, University of
Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA 19104, USA,Department of Medical Ethics and Health Policy, Perelman
School of Medicine, University of Pennsylvania, 423 Guardian Drive, Blockley Hall,
Philadelphia, PA 19104, USA,Department of Medicine, Perelman School of Medicine,
University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104,
USA,Center for Health Incentives and Behavioral Economics,
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104,
USA
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Gilheany-Black L, Davis M. Cardiovascular Health Risk Disparities in a Rural New Zealand General Practice Community. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gilheany-Black L, Davis M. Cardiology Referrals for High Cardiovascular Risk Patients in a Rural New Zealand General Practice Community. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ng L, Davis M, Anand V, Toy J, Atkins B. Is Less More? Rationalising the Use of Transthoracic and Transoesophageal Echocardiography in the Investigation of Suspected Endocarditis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hoskins K, Johnson C, Davis M, Pettit AR, Barkin S, Jager-Hyman S, Rivara F, Walton M, Wolk CB, Beidas RS. A mixed methods evaluation of parents' perspectives on the acceptability of the S.A.F.E. Firearm program. J Appl Res Child 2021; 12:2. [PMID: 36883133 PMCID: PMC9987154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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Davis M, Bellamy N. Trauma and Adversity: Factors Impacting Vulnerability and Resilience Among Older Disaster Survivors. Innov Aging 2020. [PMCID: PMC7740827 DOI: 10.1093/geroni/igaa057.1983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Most would agree that older adults represent a highly vulnerable group prior to, during and post disaster. Age-related vulnerabilities often lead into an increased risk for traumatic experiences and post-traumatic stress symptoms after a disaster. Trauma informed principles offer a possible way to reduce the vulnerability of older adults after a disaster. For example, utilizing the trauma informed question “what has happened to you” shifts the focus from a deficit approach and allows for a deeper understanding of the impact of traumatic life experiences on current functioning and reaction to the disaster. It is this understanding of trauma’s impact that may have a role in how older adult disaster survivors view, respond, and recover after a natural disaster (Seery et.al. 2010; Iacoviello & Charney, 2014). In addition, understanding the role of lifetime adversity provides critical insights for disaster planning, reducing vulnerability and promoting resilience among older disaster survivors.
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Affiliation(s)
- Molly Davis
- George Mason University, Fairfax, Virginia, United States
| | - Nikki Bellamy
- Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland, United States
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Rudd BN, Davis M, Beidas RS. Integrating implementation science in clinical research to maximize public health impact: a call for the reporting and alignment of implementation strategy use with implementation outcomes in clinical research. Implement Sci 2020; 15:103. [PMID: 33239097 PMCID: PMC7690013 DOI: 10.1186/s13012-020-01060-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/25/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although comprehensive reporting guidelines for implementation strategy use within implementation research exist, they are rarely used by clinical (i.e., efficacy and effectiveness) researchers. In this debate, we argue that the lack of comprehensive reporting of implementation strategy use and alignment of those strategies with implementation outcomes within clinical research is a missed opportunity to efficiently narrow research-to-practice gaps. MAIN BODY We review ways that comprehensively specifying implementation strategy use can advance science, including enhancing replicability of clinical trials and reducing the time from clinical research to public health impact. We then propose that revisions to frequently used reporting guidelines in clinical research (e.g., CONSORT, TIDieR) are needed, review current methods for reporting implementation strategy use (e.g., utilizing StaRI), provide pragmatic suggestions on how to both prospectively and retrospectively specify implementation strategy use and align these strategies with implementation outcomes within clinical research, and offer a case study of using these methods. CONCLUSIONS The approaches recommended in this article will not only contribute to shared knowledge and language among clinical and implementation researchers but also facilitate the replication of efficacy and effectiveness research. Ultimately, we hope to accelerate translation from clinical to implementation research in order to expedite improvements in public health.
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Affiliation(s)
- Brittany N Rudd
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Penn Implementation Science Center, Leonard Davis Institute (PISCE@LDI), Philadelphia, PA, USA.
| | - Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Implementation Science Center, Leonard Davis Institute (PISCE@LDI), Philadelphia, PA, USA
| | - Rinad S Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Implementation Science Center, Leonard Davis Institute (PISCE@LDI), Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Edwards S, Ong R, Davis M, Allcock R, Androga G, Kamien B, Harrop K, Ravenscroft G, Fietz M, Pachter N, Beilby J, Laing N. HIGHLIGHTS ACROSS MYOLOGY. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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