Process Evaluation of a Treatment Program for Mood and Anxiety Disorders Among Emerging Adults: Preentry Factors, Engagement, and Outcomes

Osuch, Elizabeth A.; Vingilis, Evelyn; Summerhurst, Carolyn; Demy, Jazzmin; Wammes, Michael; Arcaro, Justin

doi:10.1176/appi.ps.201800219

Cited by 8 publications

(9 citation statements)

References 29 publications

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“…Data from patients who declined to participate were not available to identify if their symptom scores and quality of health were substantially better than those participating. More females were enrolled in the study, which may reflect the greater numbers of females at FEMAP (Osuch et al, 2019) and seeking help for mood/anxiety challenges generally (Kessler et al, 2005). The quarantine experience is different from community to community, depending upon infection and death rates, course of pandemic progression over time, population density and a myriad of other societal factors, which need to be considered when interpreting these results.…”

Section: Discussionmentioning

confidence: 99%

“…depression, anxiety, traumatic exposures and functional impairment prior to COVID-19 (CAMH, 2017;Osuch et al, 2019;SAMHSA, 2019). It has been unclear how EAs in mental health care would withstand physical distancing, unemployment, reduced daily structure, isolation and inactivity.…”

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confidence: 99%

“…The First-Episode Mood and Anxiety Program (FEMAP), integrated into the Ontario public health care system, allows 16-25 years old EAs with mood and/or anxiety concerns to self-refer, provided they have less than 18 months total lifetime psychiatric medication use, no primary substances use disorder and no prolonged loss of consciousness from brain injury (Osuch et al, 2015(Osuch et al, , 2019. The program uses a multidisciplinary, youth-friendly, person-focused model that has no predetermined time or usage limits and attempts to provide definitive treatment for patients at no personal cost.…”

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confidence: 99%

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Monitoring the effects of COVID‐19 in emerging adults with pre‐existing mood and anxiety disorders

Osuch

Demy

Wammes

et al. 2021

Early Intervention Psych

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Aim The COVID‐19 quarantine closed many mental health services. Emerging adults with pre‐existing mood or anxiety disorders were of concern for worsening symptoms. We sought to demonstrate a method for monitoring mental health status of a group of patients with reduced access to their usual mental health services during quarantine. Methods A total of 326 patients enrolled in the First‐Episode Mood and Anxiety Program in London, Ontario, Canada were invited to participate in online questionnaires regularly. Patients were flagged for high level of risk based on depression scores, suicidal ideation and worsening in anxiety, depression or quality of health. All patients were also asked if they wanted contact with a clinician. Results One hundred and fourteen (35%) patients completed at least one questionnaire. Thirty were flagged based on scores; 37 (32.5%) participating patients requested help. Participants who were flagged for concerning scores were younger, more likely to be on the wait list for treatment, to have been laid off from work and have more functional impairment. Participants requesting support had higher symptom scores for depression and lower scores on quality of health. Conclusions The process utilized here identified patients at risk and in need of clinical support in the context of pandemic quarantine. It provided an accessible avenue for invited patients to communicate both symptom status and need for contact. Such a process can provide valuable monitoring during times when the usual communications between patients and health care providers is compromised and clinician time is limited. It is easily implemented.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Monitoring the effects of COVID‐19 in emerging adults with pre‐existing mood and anxiety disorders

Osuch

Demy

Wammes

et al. 2021

Early Intervention Psych

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“…We utilized the Logic Model, 9 a validated tool to evaluate this quality improvement initiative, over a 8-month pilot (December 2018-August 2019) ( Figure 2 ). Previous studies evaluating a variety of health initiatives have successfully applied the Logic Model, including but not limited to evaluating a treatment program for mood disorders, 10 a mobile phone-supported intervention for stroke rehabilitation, 11 and a public health program for Type II diabetes prevention and management. 12 …”

Section: Introductionmentioning

confidence: 99%

Systematic Evaluation of a Provincial Initiative to Improve Transition to Home Dialysis Therapies

Wang

Turnbull²,

Williams³

et al. 2020

Can J Kidney Health Dis

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Background: The transition from choosing to initiating home dialysis therapies (HDTs) is not clearly standardized for patients and staff, causing increased anxiety and suboptimal self-management for chronic kidney disease (CKD) patients. At BC Renal, a “Transition to HDTs” guidebook (the Guide) was designed, outlining a step-wise approach to transitioning to HDTs for patients, to help address some of these concerns. Objective: We used the Logic Model evaluation framework to assess the value of the Guide to improve patient and staff experience with transitioning to HDTs. Design: This is a prospective cohort quality improvement study. Setting: This study took place at home dialysis programs in British Columbia, Canada, with 2 pilot sites and 2 control sites. Patients: Patients above age 18 who attended kidney care clinics and identified HDT as their renal replacement treatment of choice were included in this study. Measurements: Patient demographics were obtained from British Columbia Renal Patient Records and Outcomes Management Information System, with differences analyzed using Mann-Whitney U test and chi-square test where applicable. Patient surveys were based on Likert rating scales, analyzed using Cochran-Armitage trend test. All tests were 2-sided, with P < .05 considered significant. Methods: The study enrolled patients from December 2018 to April 2019 at 2 pilot and 2 control sites. Patients were followed up for 8 months. The intervention strategies included (1) training of front-line staff to use the Guide and (2) dissemination of the guide to patients. Evaluation tools measuring data at baseline and at the 8-month point included (1) qualitative and quantitative patient surveys, (2) qualitative staff surveys, (3) structured feedback session with renal care staff, and (4) transition rate and time between choosing and starting a HDT. Results: In total, 108 patients were enrolled: 43 patients at pilot sites and 65 in control sites. Twenty-three of 65 in control vs 18 of 43 in pilot transitioned to a HDT by 8-month follow-up. Transition time was 80 vs 89 days in pilot vs control group, but it was not statistically different ( P = .37). The proportion of patients that transitioned to a HDT was 42% vs 35% in pilot vs control group ( P = .497). Patients’ anxiety, illness knowledge, and activation of resources were not significantly different between patients who successfully transitioned at control and pilot sites. During interviews, patients confirmed that the Guide was effective and helped retain knowledge. The staff felt that the intervention did not increase their workload and that the Guide was a good communication tool, but was used inconsistently. Limitations: We had a small sample size and limited number of patients enrolled who chose home hemodialysis, with none in the control group. The results are therefore more applicable to peritoneal dialysis. Conclusions: The Logic Model was useful to evaluate our multi-intervention strategy. While there were no statistically significant differences in transition time, rate, and patient anxiety with or without the Guide, qualitative opinions from patients indicate that the Guide was a useful supplement. In addition, feedback from renal care staff suggested that the Guide served as a framework for communicating the transition process with patients, and was perceived as a useful tool. Future work is required to standardize the Guide’s utilization. Trial registration: As this is a quality improvement evaluation study, trial registration is not applicable.

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“…There has been a recent surge in papers calling for early intervention approaches to be broadened to other diagnostic groups, including major depression,36 OCD,22 eating disorders37 and bipolar disorder 38. Preliminary evidence from services for recent-onset eating and mood disorders demonstrate significant improvements in symptoms, reduced hospital (re)admissions, and most importantly, high levels of patient satisfaction 39–42…”

Section: Introductionmentioning

confidence: 99%

Early intervention services for non-psychotic mental health disorders: a scoping review protocol

et al. 2019

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IntroductionWorldwide mental health disorders are associated with a considerable amount of human suffering, disability and mortality. Yet, the provision of rapid evidence-based care to mitigate the human and economic costs of these disorders is limited. The greatest progress in developing and delivering early intervention services has occurred within psychosis. There is now growing support for and calls to extend such approaches to other diagnostic groups. The aim of this scoping review is to systematically map the emerging literature on early intervention services for non-psychotic mental health disorders, with a focus on outlining how services are structured, implemented and scaled.Methods and analysisThe protocol was developed using the guidance for scoping reviews in the Joanna Briggs Institute manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. A systematic search for published and unpublished literature will be conducted using the following databases: (1) MEDLINE, (2) PsycINFO, (3) HMIC, (4) EMBASE and (5) ProQuest. To be included, documents must describe and/or evaluate an early intervention service for adolescents or adults with a non-psychotic mental health disorder. There will be no restrictions on publication type, study design and date. Title and abstract, and full-text screening will be completed by one reviewer, with a proportion of articles screened in duplicate. Data analysis will primarily involve a qualitatively summary of the early intervention literature, the characteristics of early intervention services and key findings relating to their evaluation and implementation.Ethics and disseminationThe synthesis of published and unpublished articles will not require ethical approval. The results of this scoping review will be published in a peer-reviewed journal and disseminated via social media, conference presentations and other knowledge translation activities.

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Process Evaluation of a Treatment Program for Mood and Anxiety Disorders Among Emerging Adults: Preentry Factors, Engagement, and Outcomes

Cited by 8 publications

References 29 publications

Monitoring the effects of COVID‐19 in emerging adults with pre‐existing mood and anxiety disorders

Monitoring the effects of COVID‐19 in emerging adults with pre‐existing mood and anxiety disorders

Systematic Evaluation of a Provincial Initiative to Improve Transition to Home Dialysis Therapies

Early intervention services for non-psychotic mental health disorders: a scoping review protocol

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