Families Systems & Health最新文献

{"title":"Psychiatric Health, Life Skills, and Opportunities for Wellness Program: Addressing psychiatric need through integrated consultation, collaboration, and brief episodes of care.","authors":"Rosa Ruggiero, Kyle Rutledge, Kevin Hoeper, Laura Bridges","doi":"10.1037/fsh0000930","DOIUrl":"https://doi.org/10.1037/fsh0000930","url":null,"abstract":"<p><strong>Introduction: </strong>Integrated behavioral health programs bring strong benefits to patients and health organizations including reductions in overall costs. However, obstacles to funding prevent the implementation and maintenance of these programs across the country.</p><p><strong>Method: </strong>The Psychiatric Health, Life Skills and Opportunities for Wellness (PHLOW) Program is based on the collaborative care model and seeks to provide psychiatric care through an integrated model that is financially sustainable for the organization. This pilot observational study included patients who received psychiatric care indirectly via consultations with primary care providers and directly through brief episodes of care.</p><p><strong>Results: </strong>Patient outcomes were demonstrated by score changes on the nine-item Patient Health Questionnaire and Generalized Anxiety Disorder 7 before and after participation in brief episodes of care. Overall cost of care savings was demonstrated through change over time in risk-adjusted per-member-per-month.</p><p><strong>Discussion: </strong>Patients participating in the PHLOW program showed potential drops in anxiety and depression ratings, coinciding with a reduction in mental health claims. In addition, participation in the program involved a small number of patient visits and prevented referrals to long-term psychiatry, preserving access for higher acuity presentations. This demonstration of the value of the PHLOW program has led to additional financial support of the program through the primary regional Medicaid payor, enhancing sustainability, and potentially modeling a collaboration that may be feasible for other organizations implementing integrated behavioral health programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting the role of the chief well-being officer in Veterans Health Administration: The auspicious start.","authors":"Tamara M Schult, Mary Gallagher-Seaman, Jana Boehmer, David C Mohr, Susan Stockdale, Taylor Harris, Kavitha Reddy","doi":"10.1037/fsh0000918","DOIUrl":"10.1037/fsh0000918","url":null,"abstract":"<p><strong>Introduction: </strong>Emerging evidence from private sector hospitals indicates that a chief well-being officer (CWO) can be an impactful role to lead organizational burnout mitigation efforts in health care systems. A descriptive process evaluation was conducted to learn about facilitators and barriers of integrating this role within the Veterans Health Administration (VA). A pilot intervention inclusive of three domains-culture of well-being, efficiency of practice, and personal resilience-was implemented.</p><p><strong>Method: </strong>Eight VA medical centers and two regional network offices received 18 months of implementation support from October 2021 to March 2023. Appointed CWOs were tasked with implementing key interventions in at least two work units at each location. Administrative records were used to track implementation progress. Surveys were administered to participating work units pre- and postintervention to assess changes in key measures. Qualitative interviews elicited information about intervention implementation including barriers and facilitators.</p><p><strong>Results: </strong>Not formally hiring CWOs in the role resulted in limited time to work on intervention implementation. This was insufficient and it impacted their ability to truly function in the role. Several work units experienced multiple challenges and were unable to implement the full intervention. Despite these challenges, when examining work unit changes, improvements in culture of health and well-being and change readiness were observed.</p><p><strong>Conclusion: </strong>The results support the importance of a formalized CWO role; however, findings highlight important factors that must be addressed for successful integration of role to drive intervention effectiveness. Comprehensive interventions addressing both system- and individual-level drivers of burnout show promise for improving VA workforce well-being but warrant further study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"304-316"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural healthcare workers' well-being: A systematic review of support interventions.","authors":"Mansoor Malik, Martina Penalosa, Isolde Martina Busch, Haroon Burhanullah, Christine Weston, Kristina Weeks, Cheryl Connors, Henry J Michtalik, George Everly, Albert W Wu","doi":"10.1037/fsh0000921","DOIUrl":"10.1037/fsh0000921","url":null,"abstract":"<p><strong>Introduction: </strong>Although there is increased awareness about healthcare workers' (HCWs') stress and burnout after the COVID-19 pandemic, support interventions should be tailored according to the needs of HCWs. Given the unique challenges rural HCWs face, we sought to systematically identify the types of interventions specifically designed and utilized to support the well-being of HCWs practicing in rural settings.</p><p><strong>Method: </strong>We conducted a comprehensive search of the existing literature through electronic databases to identify quantitative, qualitative, and mixed-methods studies describing supportive interventions for rural HCWs with well-being-related outcomes between January 1, 2023 and March 31, 2023. We used the Effective Public Health Practice Project, Mixed Methods Assessment Tool, and Joanna Briggs Institute Critical Appraisal Checklist to evaluate the study quality.</p><p><strong>Findings: </strong>Out of 1,583 identified records, 25 studies were included in the analysis. The studies described a wide range of supportive interventions and outcomes. The overall quality of the studies was weak to moderate. None of the studies were randomized and only six included controls. Included interventions were generally well- accepted. Quantitative and qualitative themes identified shared decision making, effective supervision, and proactive cultural change as promising interventions that warrant further exploration. Financial interventions alone were not effective. Most of the studies were either unfunded or were funded internally by the institutions.</p><p><strong>Conclusions: </strong>There is limited research in support interventions for rural HCWs. Larger, well-designed studies are needed to explore promising interventions to promote well-being of rural healthcare workforce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"355-374"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectively addressing burnout, well-being, and resilience: Individual, team, and system approaches.","authors":"Abbie O Beacham, Megan Call, Norah Janosy, Emily DeBoer","doi":"10.1037/fsh0000926","DOIUrl":"https://doi.org/10.1037/fsh0000926","url":null,"abstract":"<p><p>This is an introduction to the special section \"Effectively Addressing Burnout, Well-being and Resilience.\" In this special section, we aimed to present work that is uniquely pertinent to the mission of <i>Families, Systems and Health</i>. While the authors welcomed work that focused on the study of burnout, well-being, and/or resilience among individual clinicians, they were especially interested in more \"upstream\" study of these topics among health care teams and systems-level interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"299-303"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can a growth mindset-supportive learning environment in medical school promote student well-being?","authors":"Zachary M Himmelberger, Yoi Tibbetts, Kenneth E Barron, Chris S Hulleman, Gevork Harootunian, Mark R Speicher","doi":"10.1037/fsh0000915","DOIUrl":"https://doi.org/10.1037/fsh0000915","url":null,"abstract":"<p><strong>Introduction: </strong>There is a growing concern for physician and medical student well-being and burnout. Growth mindset, or the belief that ability can be developed, as well as students' perception of their instructors' growth mindset, have been associated with better academic outcomes for a wide range of students. The primary purpose of the present study was to investigate the effects of growth mindset on medical student well-being.</p><p><strong>Method: </strong>We recruited all graduating osteopathic medical students in the class of 2023. This survey included items about student demographics (including identifiable items), experiences in medical school, practice plans, along with financial and other information. The survey of 667 items required a median time of 33 min to complete. Our sample consisted of 4,180 students. Students self-reported growth mindset, perception of instructor growth mindset, and four measures of well-being: flourishing, resilience, burnout, and maladaptive psychological symptoms.</p><p><strong>Results: </strong>Growth mindset and perception of instructor growth mindset were significant predictors of medical student well-being. Further, significant interactions showed that these effects were strongest for students from historically marginalized backgrounds.</p><p><strong>Discussion: </strong>Our work provides a first step toward addressing physician burnout by targeting medical students, which could prevent them from beginning their careers already in a state of burnout. We argue that systemic change is needed to improve student well-being, such as emphasizing growth mindset-supportive pedagogy, which places the emphasis on changing systems instead of individuals. Future research should include causal analyses to better understand the effect and persistence of growth mindset-supportive environments on student well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"343-354"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated care identity: Evolutionary leaps and future directions.","authors":"Deepu George, Jason Herndon","doi":"10.1037/fsh0000925","DOIUrl":"https://doi.org/10.1037/fsh0000925","url":null,"abstract":"<p><p>As integrated care becomes mainstream, adaptively framing team members' identities based on their work context will help align their attitudes and required competencies. This article explores the emergence of integrated care identity, focusing on behavioral health professionals, and offers suggestions for future development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"478-483"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowing.","authors":"Amy Basilious","doi":"10.1037/fsh0000869","DOIUrl":"https://doi.org/10.1037/fsh0000869","url":null,"abstract":"<p><p>In this narrative, the author describes how she hears the story of someone who is the victim of abuse, but the author could not have known about the vicitm's abuse and many fears. These fears include fear of others' judgment, fear of screams, fear of abandonment, and fear of being with others. In these stories, the author has heard the unspoken burdens of others around her. This particular victim has taught the author compassion, empathy, and patience when she interacts with her patients, colleagues, and friends. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"469-470"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a culture of workforce wellness using implementation science-informed strategies: A qualitative content analysis.","authors":"Jessica J Reed, Frances E Fachilla, Alton N Verbist, Hannah G McClellan, Christina A Gillim, Shane T W Kuhlman","doi":"10.1037/fsh0000924","DOIUrl":"https://doi.org/10.1037/fsh0000924","url":null,"abstract":"<p><strong>Introduction: </strong>Successfully addressing burnout in health and human services settings is a topic of growing interest and impact in the field. Implementation science gives us strategies to build organizational readiness to create a culture of workforce wellness. This study used strategies for identifying and preparing wellness champions and building feedback loops to begin to build a culture of workforce wellness. The primary aim of this study was to assess perspectives on establishing feedback loops across all levels of the organizational hierarchy.</p><p><strong>Method: </strong>This study took place in a community mental health organization that provides services across four different states. Champions in each state were identified and connected with leaders and teams. The champions supported the engagement of leaders and the design of feedback loops. Champions remained engaged throughout the process of assessing needs and sharing workforce wellness data. A qualitative content analysis was conducted on data collected during meetings that were intended to create organizational practice to policy feedback loops.</p><p><strong>Results: </strong>Staff across all levels of the organizational hierarchy shared feedback and participated in facilitated reflective discussion. Participants offered several suggestions for addressing burnout. Across all participants, workplace connections were perceived as a protective factor against burnout.</p><p><strong>Discussion: </strong>This implementation science strategy to help combat burnout is an effective and feasible way to include frontline staff voices and build connection and trust between leaders and staff in health and human services settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"380-385"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting successful health care transitions for young people aging out of foster care.","authors":"James Kaferly, Liza M Creel","doi":"10.1037/fsh0000927","DOIUrl":"https://doi.org/10.1037/fsh0000927","url":null,"abstract":"<p><p>Improving adolescent to adult health care transitions (HCTs) would benefit all young people in the United States but has particular importance for the more than 120,000 adolescents and young adults (AYA) placed in foster care. Leveraging clinical guidelines and evidence-based interventions, HCT efforts inclusive of and specific to AYA placed in foster care can be strengthened through greater collaboration between child welfare, health care, and other AYA-serving systems. This Health Policy Brief advances the importance of structured Health Care Transition services for adolescents and young adults placed in foster care. Additionally, it highlights opportunities for health care providers, youth-serving systems, and health policy stakeholders to collaborate with child-welfare involved young people in order to prioritize evidence-based health care transition interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"42 3","pages":"464-468"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Integrated behavioral health plus\": The best of the worlds of collaborative care management, primary care behavioral health, and primary care.","authors":"Gene A Kallenberg, William J Sieber","doi":"10.1037/fsh0000885","DOIUrl":"10.1037/fsh0000885","url":null,"abstract":"<p><strong>Introduction: </strong>Discussions comparing the components and virtues of models of integrated behavioral health (IBH), that is, collaborative care management and primary care behavioral health, have been ongoing. In this conceptual article, we recommend shifting the focus to a broader set of components we have found essential to serve the needs of our patients, and hopefully the broader aims of dissemination and implementation of IBH.</p><p><strong>Method: </strong>We detail our 20-year experience including the personnel, program components, challenges, successes, and plans for the future that will meet our patients' behavioral health needs and serve primary care.</p><p><strong>Results: </strong>We compare our \"IBH Plus\" approach using the central tenets of primary care known as the \"six Cs\" (6Cs) to two dominant models, illustrating differences and similarities among them. The \"6Cs\" are first contact/accessibility, continuity, comprehensiveness, coordination, context-based, and accountability. We detail how each of these \"6Cs\" guides the structure and functioning of IBH Plus in the team-based patient-centered medical home setting.</p><p><strong>Discussion: </strong>We believe IBH Plus more clearly relates to and supports the rest of the primary care transformation movement while integrating components of the most popular models of IBH and may support greater implementation of IBH. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"454-463"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}