A Women’s Health Clinic for a Safety-Net Inpatient Psychiatry Unit: Project PETIT

James, Monique; Peterson, Alissa; Mangurian, Christina

doi:10.1176/appi.ps.69804

Cited by 5 publications

(1 citation statement)

References 1 publication

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“…This group was convened and led by members of the primary research team. The primary research team comprised investigators with a track record of collaboration as well as expertise in both scientific and technological aspects of this project, including MS clinical trials (RB), digital tools to evaluate and treat cognition and mood in MS [16] (RB and AF), psychiatric care for underserved populations and innovations in treatment of psychiatric conditions in diverse settings (CM) [37][38][39][40][41][42][43][44], implementation science (CM), statistics (Ann Lazar), patient engagement (RB and JR) [20,21,25], HCD of digital tools (JR, RB, NS, and NM) [20,21,25], and launching an institutionally and technologically sophisticated, scalable, cross-disease platform from the EHR at UCSF (RB and BRIDGE team). The stakeholder advisory group included the research team listed above, as well as a patient champion JS, patient advocacy group leader Linda Glassel, National Multiple Sclerosis Society, Northern California Chapter President, MS nurse expert AM, Registered Nurse, social worker MD licensed independent clinical social worker, and MS neurologist CYG.…”

Section: Stakeholder Advisory Groupmentioning

confidence: 99%

A Closed-Loop Digital Health Tool to Improve Depression Care in Multiple Sclerosis: Iterative Design and Cross-Sectional Pilot Randomized Controlled Trial and its Impact on Depression Care

Henderson,

Reihm,

Koshal

et al. 2024

JMIR Form Res

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Background People living with multiple sclerosis (MS) face a higher likelihood of being diagnosed with a depressive disorder than the general population. Although many low-cost screening tools and evidence-based interventions exist, depression in people living with MS is underreported, underascertained by clinicians, and undertreated. Objective This study aims to design a closed-loop tool to improve depression care for these patients. It would support regular depression screening, tie into the point of care, and support shared decision-making and comprehensive follow-up. After an initial development phase, this study involved a proof-of-concept pilot randomized controlled trial (RCT) validation phase and a detailed human-centered design (HCD) phase. Methods During the initial development phase, the technological infrastructure of a clinician-facing point-of-care clinical dashboard for MS management (BRIDGE) was leveraged to incorporate features that would support depression screening and comprehensive care (Care Technology to Ascertain, Treat, and Engage the Community to Heal Depression in people living with MS [MS CATCH]). This linked a patient survey, in-basket messages, and a clinician dashboard. During the pilot RCT phase, a convenience sample of 50 adults with MS was recruited from a single MS center with 9-item Patient Health Questionnaire scores of 5-19 (mild to moderately severe depression). During the routine MS visit, their clinicians were either asked or not to use MS CATCH to review their scores and care outcomes were collected. During the HCD phase, the MS CATCH components were iteratively modified based on feedback from stakeholders: people living with MS, MS clinicians, and interprofessional experts. Results MS CATCH links 3 features designed to support mood reporting and ascertainment, comprehensive evidence-based management, and clinician and patient self-management behaviors likely to lead to sustained depression relief. In the pilot RCT (n=50 visits), visits in which the clinician was randomized to use MS CATCH had more notes documenting a discussion of depressive symptoms than those in which MS CATCH was not used (75% vs 34.6%; χ21=8.2; P=.004). During the HCD phase, 45 people living with MS, clinicians, and other experts participated in the design and refinement. The final testing round included 20 people living with MS and 10 clinicians including 5 not affiliated with our health system. Most scoring targets for likeability and usability, including perceived ease of use and perceived effectiveness, were met. Net Promoter Scale was 50 for patients and 40 for clinicians. Conclusions Created with extensive stakeholder feedback, MS CATCH is a closed-loop system aimed to increase communication about depression between people living with MS and their clinicians, and ultimately improve depression care. The pilot findings showed evidence of enhanced communication. Stakeholders also advised on trial design features of a full year long Department of Defense–funded feasibility and efficacy trial, which is now underway. Trial Registration ClinicalTrials.gov NCT05865405; http://tinyurl.com/4zkvru9x

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Section: Stakeholder Advisory Groupmentioning

confidence: 99%

A Closed-Loop Digital Health Tool to Improve Depression Care in Multiple Sclerosis: Iterative Design and Cross-Sectional Pilot Randomized Controlled Trial and its Impact on Depression Care

Henderson,

Reihm,

Koshal

et al. 2024

JMIR Form Res

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Cervical Cancer Screening Among Female Medicaid Beneficiaries With and Without Schizophrenia

Hwong,

Murphy,

Vittinghoff

et al. 2024

Schizophrenia Bulletin

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Background and Hypothesis In the United States, women with schizophrenia face challenges in receiving gynecologic care, but little is known about how cervical cancer screening rates vary across time or states in a publicly insured population. We hypothesized that women Medicaid beneficiaries with schizophrenia would be less likely to receive cervical cancer screening across the United States compared with a control population, and that women with schizophrenia and other markers of vulnerability would be least likely to receive screening. Study Design This retrospective cohort study used US Medicaid administrative data from across 44 states between 2002 and 2012 and examined differences in cervical cancer screening test rates among 283 950 female Medicaid beneficiaries with schizophrenia and a frequency-matched control group without serious mental illness, matched on age and race/ethnicity. Among women with schizophrenia, multivariable logistic regression estimated the odds of receiving cervical cancer screening using individual sociodemographics, comorbid conditions, and health care service utilization. Study Results Compared to the control group, women with schizophrenia were less likely to receive cervical cancer screening (OR = 0.76; 95% CI 0.75–0.77). Among women with schizophrenia, nonwhite populations, younger women, urban dwellers, those with substance use disorders, anxiety, and depression and those connected to primary care were more likely to complete screening. Conclusions Cervical cancer screening rates among US women Medicaid beneficiaries with schizophrenia were suboptimal. To address cervical cancer care disparities for this population, interventions are needed to prioritize women with schizophrenia who are less engaged with the health care system or who reside in rural areas.

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Pathway Home: An Innovative Care Transition Program From Hospital to Home

Petit¹,

Graham²,

Granek³

2018

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A Women’s Health Clinic for a Safety-Net Inpatient Psychiatry Unit: Project PETIT

Cited by 5 publications

References 1 publication

A Closed-Loop Digital Health Tool to Improve Depression Care in Multiple Sclerosis: Iterative Design and Cross-Sectional Pilot Randomized Controlled Trial and its Impact on Depression Care

A Closed-Loop Digital Health Tool to Improve Depression Care in Multiple Sclerosis: Iterative Design and Cross-Sectional Pilot Randomized Controlled Trial and its Impact on Depression Care

Cervical Cancer Screening Among Female Medicaid Beneficiaries With and Without Schizophrenia

Pathway Home: An Innovative Care Transition Program From Hospital to Home

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