RAND-University of Pittsburgh Health Institute
Mental Health
Description
The RUPHI-WPIC Mental Health Pilot Grant Program provided funding for pilot health services research studies that focus on mental health to ultimately reduce the burden of mental illness.
Funding Period
July 21, 2008 - July 28, 2009
Grantees
| University of Pittsburgh Investigator | RAND Investigator | Title of Project |
|---|---|---|
| Brian Primack, MD Jennifer Silk, PhD |
William Shadel, PhD | Investigating Associations between Media Use, Depression, and Anxiety using Ecological Momentary Assessment (EMA) |
| Carrie Farmer Teh, PhD | Andrew Dick, PhD | Assessing the quality of depression care among Medicaid-enrolled adults using chart abstraction |
| Ellen Frank, PhD | Ellen Beckjord, PhD | Interpersonal and Social Rhythm Therapy for Women with Breast Cancer: Facilitating the Transition out of Treatment and into Survivorship |
Abstracts
Investigating Associations between Media Use, Depression, and Anxiety using Ecological Momentary Assessment (EMA)
Brian A. Primack, MD, EdM, MS, University of Pittsburgh
Jennifer S. Silk, PhD, University of Pittsburgh
William G. Shadel, PhD, RAND
Adolescence is a critical period for the development of affective disorders such as depression and anxiety. Exposure to mass media may be an important socioenvironmental factor that contributes to affective dysfunction in adolescents. Adolescents are exposed to media messages over 8 hours per day, and preliminary reports suggest that these conditions are linked to mass media exposure. However, little is known about what particular types of media content—and what media-related contextual factors—are most associated with affective dysregulation in adolescents. This application capitalizes on the complementary expertise of researchers at the University of Pittsburgh, the Western Psychiatric Institute and Clinic, and RAND to advance this program of research.
This project will leverage an extant data set that includes information collected in real time via Ecological Momentary Assessment (EMA). This data set contains detailed media exposures (e.g., music, television, movies, Internet, and video games) among 126 adolescents with and without Major Depressive Disorder and/or Anxiety Disorders. First, we will use this data set to develop and validate a coding scheme to accurately classify content- and context-based variables related to media exposure that may contribute to adolescent affective dysregulation. We will then evaluate the associations between these media-related variables and psychiatric diagnoses in this sample. These pilot data will be used to develop R01 grant applications to the National Institutes of Health using this coding scheme and EMA to investigate a variety of questions regarding the relationship between media exposure and development of psychiatric symptoms and conditions in adolescents.
Assessing the Quality of Depression Care among Medicaid-Enrolled Adults Using Chart Abstraction
Carrie Farmer Teh, PhD, University of Pittsburgh
Andrew Dick, PhD, RAND
The quality of depression care in the U.S. is poor and current methods to measure depression care quality are inadequate, as it is unknown whether these measures are associated with clinical outcomes, healthcare utilization or expenditures. We are planning a large project to address this gap by exploring the relationship between depression care quality and outcomes using administrative data and chart abstraction. The proposed RUPHI study will develop the methodology for assessing measures of depression treatment quality using chart abstraction and will evaluate the feasibility of doing this in the larger study. We plan to develop a chart abstraction tool to assess the quality of depression care and will then implement a pilot project using this tool to abstract data on depression care quality from the medical charts of 120 depressed adult Medicaid beneficiaries in Pennsylvania whose mental health care is managed by the Community Care Behavioral Health Organization. The anticipated products from this project include a well tested chart abstraction tool and data that can be used for power calculations and design of a sampling frame, and experience conducting chart abstractions. These products and the knowledge gained from this process will be used to inform the development of a substantial grant proposal (R01) to NIMH to fund the proposed larger project.
Interpersonal and Social Rhythm Therapy for Women with Breast Cancer: Facilitating the Transition out of Treatment and into Survivorship
Ellen Burke Beckjord, PhD, MPH, RAND
Ellen Frank, PhD, University of Pittsburgh
During the transition out of primary cancer treatment and into survivorship, patients often find themselves feeling uncertain about the future and lost in the transition back to “normal” life. Interpersonal and Social Rhythm Therapy (IPSRT) is an empirically validated psychological intervention for the treatment of bipolar mood disorders. However, with a focus on the regulation of social and circadian rhythms and interpersonal relationships, IPSRT is uniquely positioned to address the challenges faced by women with breast cancer during and after the transition out of primary treatment. Further, given the evidence that disregulation of circadian rhythms is associated with cancer incidence, progression, and survival, IPSRT may also positively affect physical health outcomes for breast cancer survivors.
We will collect quantitative and qualitative data on psychosocial and social rhythm disruption before and after the transition out of primary cancer treatment among women diagnosed with Stage 0-III breast cancer. Quantitative data will be used to measure psychological outcomes and social rhythms before and after the transition out of primary treatment and qualitative data will be used to inform the adaptation of the current IPSRT protocol for use with breast cancer survivors.
The current study will lay the foundation for a translational program of survivorship research. Using pilot data from this project we will design a randomized controlled trial to test whether an IPSRT intervention adapted for use with cancer survivors results in less psychosocial and social rhythm disruption during the transition out of primary treatment and in better health outcomes for cancer.