UC Davis Health System officials and California Senate leader Darrell Steinberg today announced the founding of a unique academic research center designed to improve mental health in California and serve as a national model for advancing innovative research in neuroscience, as well as the prevention of and early interventions in mental illness.
Known as the Behavioral Health Center of Excellence at UC Davis, the $7.5 million project will become the university’s hub for bringing together its wide-ranging research, education, clinical care and community engagement as they relate to neuroscience, mental health and public-health improvement.
The new center will be located on the university’s Sacramento campus. It will complement a similar, $7.5 million center that is being established in Southern California at UCLA.
“Mental health is an issue that knows no partisan lines. Its impacts and suffering escape no race, class, gender, age, or sexual orientation. It affects every other agenda we address in the Legislature.” Steinberg said. “Having dedicated behavioral-health centers in the state will be the catalyst for improving our understanding of the human mind and finding answers for individuals and their families.”
Grant funding for the two centers was approved by the state’s Mental Health Services Oversight and Accountability Commission earlier this year. UC Davis plans call for researchers to explore everything from telehealth delivery of behavioral health care and the economics of prevention to how medical and mental-health services might be better integrated in clinical settings.
“This center is so promising because it enables UC Davis to work from its core strengths in brain research, new technologies for clinical care, reducing health disparities and effectively engaging communities,” said Frederick Meyers, vice dean of UC Davis School of Medicine and who will serve as director of the new center. “We plan to closely measure and evaluate our research results so that we can identify and translate into practice the best ways to achieve behavioral-health improvement.”
Meyers said the UC Davis center will be a catalyst for developing more research expertise in behavioral health, as well as better techniques and training to address wellness, recovery and resilience to mental illness. The university plans to partner in its research efforts with other health organizations and government-related institutions, including counties throughout Northern California.
The new center’s leadership team, which includes Cameron Carter, a UC Davis professor of psychiatry and behavioral sciences specializing in the early diagnosis and treatment of schizophrenia and other cognitive mental disorders, will also study community programs, alternatives to hospitalization, shared services with jails, hospitals and courts, and identify new approaches to reducing mental-health stigmas.
“The center of excellence in behavioral health is one product of the work we started many years ago with Proposition 63 and the state’s Mental Health Services Act,” said Steinberg, a longtime leader on mental-health issues. “Like the UC Davis’ MIND Institute, which has earned international recognition for its work in autism, the Behavioral Health Center of Excellence at UC Davis can bring together in one place the academic skills, talent and experience that we need to address some of the most challenging problems that many California families are facing.”
2014 Outcomes Research Pilot Awards
The CHPR is proud to announce the recipients of the 2014 Outcomes Research Pilot Awards. The 2014 Pilot Awards are a joint project of the Center for Healthcare Policy and Research, the UC Davis School of Medicine, the UC Davis Clinical and Translational Science Center, and the Betty Irene Moore School of Nursing.
Janice Bell Ph.D., M.P.H., M.N. (Betty Irene Moore School of Nursing)
"Novel personal health network technology to enhance nurse-directed early palliative care for cancer patients: A pilot study to establish a randomized clinical trial"
Specific Aim 1: To establish the participatory governance structure for our future PCORI proposal that assures the deep, sustained, and meaningful engagement of patient, caregiver and clinician stakeholders in the planning and implementation of the study--from design through recruitment methods, patient reported outcome definition, data analysis and dissemination.
Specific Aim 2: To gather preliminary data to describe the experiences, symptom profiles, patient reported outcomes and health care utilization of cancer patients receiving usual care services in a comprehensive cancer care center.
Specific Aim 3: Among patients and their caregivers, to identify patient-centered features and functions of the PHN for palliative care and evaluate potential acceptance and use of the technology.
Lorien Dalrymple, M.D., M.P.H. (Department of Internal Medicine)
"Ensuring safe transitions from the hospital to the outpatient dialysis center"
Specific Aim 1. To engage key stakeholders and identify opportunities to improve transitions of care from the hospital to the outpatient dialysis facility, with the goals of lowering the rate of hospital readmissions and post-hospital ED visits and enhancing communication between the hospital and outpatient dialysis facility.
Specific Aim 2: To develop patient-level and outpatient dialysis facility-level interventions that improve transitions of care from the hospital to the dialysis facility.
Specific Aim 3: To pilot test patient-level and outpatient dialysis facility-level interventions that improve transitions of care from the hospital to the dialysis facilty.
Specific Aim 4: To identify outpatient free-standing dialysis facilities willing to participate in a national multicenter cluster randomized trial to test the develped interventions in a national sample.
Aims 1-4 will support the development of a grant proposal to be submitted to the Patient-Centered Outcomes Research Institute (PCORI) in 2015, our outlined aims will provide the stakeholder engagement and preliminary data necessary for a successful grant application to PCORI. Our final research product will be a grant that proposes a national multicenter cluster randomized trial to test a bundle of interventions aimed at improving the transition of care from the hospital to the dialysis facility in adults with ESRD receiving in-center hemodialysis.
Glen L. Xiong, M.D., C.M.D. (Department of Psychiatry and Behavioral Sciences)
"Antipsychotic prescription decision making and use in a diverse cohort of dementia patients"
Specific Aim 1: We will examine patterns of antispychotic use in African American, Asian and Latino minority groups compared with white non-Hispanic patients using retrospective data analysis.
Specific Aim 2: We will conduct qualitative interviews to understand the experiences and perspectives of ethnically diverse caregivers related to their decisions about use of antipsychotics. This will also examine caregiver knowledge, attitudes and preferences with regard to the treatment of NPS. In order to plan a patient- and family-centered multimodal intervention, we will elicit caregiver perspectives regarding the types of interventions that would be most helpful to them in the decision making process.
UC Davis study researches potential link to care for mothers battling depression: their child's pediatrician
Pediatricians will screen mothers for depression in a new research study conducted at UC Davis Children's Hospital. The grant is funded by the National Institute of Mental Health.
Depression in mothers parenting young children is common and undertreated. About one out of every five women will experience a bout with depression at some point while parenting a child, with most of those episodes occurring in the first year of a newborn's life. Studies have found that depression can negatively affect a mother's parenting and is associated with mental, behavioral and physical health problems in their children.
Researchers at UC Davis have been rethinking ways of reaching out to mothers of young children to identify those who may need help.
"Mothers may see their child's pediatric provider more often than their own adult provider. They also may be more motivated to seek care for depression if it is placed in the context of their children's health, so pediatric visits offer a significant opportunity to intervene," said Erik Fernandez y Garcia, lead investigator of the study. Fernandez y Garcia is a CHPR member and a graduate of our Primary Care Outcomes Research (PCOR) fellowship program.
In a recent pilot study, Fernandez y Garcia developed and tested a pediatric clinic-based intervention that included a depression screening and education for mothers, with a focus on explaining how depression care can improve the health of their children. Referral guidance and support were also provided.
The pilot study demonstrated that for the mothers who tested positive for depression in the screening, those who received the targeted pilot intervention sought help for their depression more frequently than mothers who received the type of non-targeted general depression advice they would get from their own doctor. The new study looks to refine the pilot intervention to increase its effectiveness and broaden its use to monolingual Spanish-speaking mothers.
"It's our hope that in this study, we will be able to better understand the support mothers will need to seek help for their maternal depression more often through this new channel - their child's pediatrician," said Fernandez y Garcia.
CHPR Member Bakerjian named to prestigious nursing academy fellowship
The American Academy of Nursing announced this week that Debra Bakerjian, an assistant adjunct professor and senior director for nurse practitioner and physician assistant clinical education and practice at the Betty Irene Moore School of Nursing, was selected as one of 168 nurse leaders nationwide for fellowship in the prestigious academy.
The Academy consists of more than 2,200 nurse leaders in education, management, practice, policy and research. Fellows include hospital and government administrators, college deans and renowned scientific researchers. Bakerjian joins five other UC Davis faculty who are also fellows in the Academy: Dean Heather M. Young, Associate Dean Deborah Ward and Professors Mary Lou de Leon Siantz, Theresa Harvath and Jeri Bigbee. However, they were inducted to the academy prior to their appointments at UC Davis. Bakerjian is the first Betty Irene Moore School of Nursing faculty member to be selected for fellowship as a member of its faculty.
Bakerjian joined the School of Nursing in 2009 as a postdoctoral scholar and in fall 2010 was appointed an assistant adjunct professor. Along with School of Medicine faculty, she led the transition of the UC Davis nurse practitioner and physician assistant programs to the School of Nursing. In 2012, she was selected as a fellow in the American Academy of Nurse Practitioners.
“The American Academy of Nursing welcomes the stellar cohort of new fellows,” said Academy president Diana Mason. “As clinicians, researchers, educators, executives and leaders in all sectors of our society, they are joining the nation’s thought leaders in nursing and health care.”
Selection criteria include evidence of significant contributions to nursing and health care and sponsorship by two current Academy fellows. Applicants are reviewed by a panel comprising elected and appointed fellows, and selection is based, in part, on the extent the nominee’s nursing career has influenced policies and the health and well-being of all. The Class of 2014 fellows will be inducted during the Academy’s Transforming Health, Driving Policy Conference on Oct. 19 in Washington, D.C.
About the Betty Irene Moore School of Nursing at UC Davis
The Betty Irene Moore School of Nursing at UC Davis was established in March 2009 through a $100 million commitment from the Gordon and Betty Moore Foundation, the nation's largest grant for nursing education. The vision of the Betty Irene Moore School of Nursing is to transform health care through nursing education and research. The school’s first programs, doctoral and master’s degrees, opened in fall 2010. Master’s degree programs for nurse practitioners and physician assistants, with a focus on preparing primary-care providers for rural and underserved communities, opened in summer 2013. The Betty Irene Moore School of Nursing is part of UC Davis Health System, an integrated, academic health system encompassing the UC Davis School of Medicine, UC Davis Medical Center and the UC Davis Medical Group. For more information, visit nursing.ucdavis.edu.
The vast majority of injuries and illnesses in agriculture are not counted
(SACRAMENTO, Calif.) — April 8, 2014
Federal agencies responsible for tracking workplace hazards fail to report 77 percent of the injuries and illnesses of U.S. agricultural workers and farmers, new research from UC Davis has found. The lack of complete data greatly reduces the chances that safety and health risks for the nation’s food suppliers will be corrected.
Published in the April issue of the Annals of Epidemiology and led by J. Paul Leigh, professor of public health sciences and researcher with the UC Davis Center for Healthcare Policy and Research, the study confirms the long-held belief that government reports dramatically and routinely undercount agricultural injuries and illnesses, ranging from chemical exposures to musculoskeletal injuries.
“Whatever anyone might have assumed about gaps in government statistics for agriculture, our study shows that the problem is actually about three times bigger than previously suspected,” said Leigh.
According to Leigh, the primary reasons for the discrepancy are the government’s focus on mid- to large-sized farming enterprises, which represent less than 50 percent of employment in the agricultural industry, along with the part-time nature of farm work and undisclosed information about injuries.(Full Article)
New insights into controlling pediatric obesity
(SACRAMENTO, Calif.) — January 29, 2014
Childhood obesity is a growing epidemic. Almost one-third of children in this country are overweight or obese, but how can we stem the tide? One idea is to use electronic health records (EHRs) to help clinicians intervene more aggressively. Programmed alerts could spur caregivers to order key tests and educate patients and families. But how does this approach work in the real world?
In a study published earlier this month in the American Journal of Medical Quality, researchers at UC Davis found mixed results. While EHR alerts definitely changed physician behavior when treating overweight and obese children, they are no magic bullet. The authors believe EHRs must be incorporated into a more comprehensive strategy to help patients overcome their weight issues.
“The alerts led to significant but not dramatic improvements,” said Ulfat Shaikh, lead researcher, pediatrician and director of Healthcare Quality at the UC Davis School of Medicine. “We believe any electronic record intervention must be combined with other approaches.”
To measure whether EHRs enhance practice, the researchers added obesity-related alerts to health records at the UC Davis Health System’s outpatient clinic, which cares for about 12,000 children each year. The alert — highlighted in bright yellow on the screen — warned physicians when a patient’s weight hit the 85th percentile, which is considered "overweight."
The EHR alert guided physicians through a series of steps to address weight issues. They were encouraged to educate patients and families about diet, exercise, screen time and other behaviors associated with obesity, as well as to document these discussions, order lab tests, refer patients to dietitians and schedule follow-ups.
The alerts had a positive impact, increasing the proportion of children diagnosed as overweight or obese from 40 percent in the pre-alert group to 57 percent in the alert group. Lab tests for diabetes and dyslipidemia (abnormal cholesterol and fat levels in the blood) increased from 17 to 27 percent. Follow-up appointment scheduling went from 24 to 42 percent. However, referrals to dietitians remained static at 13 percent. (Full Article)
Health System IT team honored for state's first electronic referral for smoking cessation
The Sacramento County Tobacco Control Coalition has honored UC Davis Health System’s Electronic Medical Records (EMR) team for creating the first two-way e-referral with the California Smokers' Helpline (1-800-NO-BUTTS) in the state.
The new electronic records’ process ensures that smokers are contacted within one to two business days by Helpline, whose free telephone counseling support doubles a smoker’s chances of quitting. An added benefit of the new feedback process is that clinical providers receive a results message back from Helpline staff about their encounters with smokers.
“Since it can take multiple attempts before a smoker quits for good, this e-referral is an important systems change that provides cessation help at every clinical encounter," said Elisa Tong, associate professor of internal medicine and one of the champions of the new process. “In six months, we have had more than 280 e-referrals from a variety of clinics and departments. Care providers say they noticed a real benefit from the Helpline’s results feedback and follow-up support.”
The California Smokers’ Helpline is a free, statewide quit-smoking service operated by UC San Diego's Moores Cancer Center. The Helpline offers self-help materials, referral to local programs, and one-on-one telephone counseling.
Tong credited fellow internist Hien Nguyen, medical director of UC Davis’ EMR system, and Clinical Information Systems specialist Willy Bansi with much of the design work and implementation. She said Nguyen’s leadership helped prioritize development of the project, which has attracted state and national interest. Tong also noted that Anthony Mayoral, the Helpline's director of Data Management and Information Systems, developed the underlying e-referral interface.
“Automated reminders and reliable follow-up information are among the great advantages of electronic medical records,” added Tong. “It’s a high-tech tool that helps improve quality of care. And when it comes to helping a smoker to quit, health-care providers need every possible tool in their medical kit."
Funding from the Affordable Care Act supported the development of UC Davis’ e-referral project. A UC Center for Health Quality and Innovation fellowship grant also supports Tong’s work in developing and promoting tobacco-cessation tools. Tong says the UC Davis team is planning to assist the other UC medical center campuses in launching similar e-referral programs.