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Evidence shows that when an interprofessional (IP) approach is effectively implemented, it can counteract some of our most pressing health care problems. One such challenge is the lack of training in IP teamwork health care professionals receive during their education. Using a quasi-experimental matched comparison group design, this study assessed pre- and posttest changes in IP knowledge, attitudes, and skills of MSW students (N = 52) from 2015-2017, who received a specialized curriculum, and clinical internships working in IP teams, compared to an internal control group involving clinical IP teams alone. Two validated measures assessed changes in students' IP knowledge, values, and skills. Quantitative findings and qualitative responses to open-ended questions elucidate barriers and facilitative factors in IP teams.

Introduction: Integrated health care is utilized in primary care clinics to meet patients' physical, behavioral, and social needs. Current methods to collect and evaluate the effectiveness of integrated care require refinement. Using informatics and electronic health records (EHR) to distill large amounts of clinical data may help researchers measure the impact of integrated care more efficiently. This exploratory pilot study aimed to (a) determine the feasibility of using EHR documentation to identify behavioral health and social care components of integrated care, using social work as a use case, and (b) develop a lexicon to inform future research using natural language processing. Method: Study steps included development of a preliminary lexicon of behavioral health and social care interventions to address basic needs, creation of an abstraction guide, identification of appropriate EHR notes, manual chart abstraction, revision of the lexicon, and synthesis of findings. Results: Notes (/V = 647) were analyzed from a random sample of 60 patients. Notes documented behavioral health and social care components of care but were difficult to identify due to inconsistencies in note location and titling. Although the interventions were not described in detail, the outcomes of screening, referral, and brief treatment were included. The integrated care team frequently used EHR to share information and communicate. Discussion: Opportunities and challenges to using EHR data were identified and need to be addressed to better understand the behavioral health and social care interventions in integrated care. To best leverage EHR data, future research must determine how to document and extract pertinent information about integrated team-based interventions. Public Significance Statement This paper assesses the feasibility of EHR (electronic health record) documentation to better understand aspects of integrated care that address behavioral health and social needs. More information on these aspects of care can help health systems identify, track, and evaluate the delivery of integrated care and how it may be improved to meet an individual's whole-health needs. Keywords: electronic health records, integrated care, team-based care, behavioral health providers, natural language processing (NLP) Supplemental materials: https://doi.org/10.1037/fsh0000584.supp, Health systems are rapidly implementing integrated health models in primary care clinics (Balasubramanian et al., 2017; Blount & Miller, 2009; Butler et al., 2008), and with good reason. Evidence indicates [...]

Introduction: Evidence supports that integrated behavioral health care improves patient outcomes. Colocation, where health and behavioral health providers work in the same physical space, is a key element of integration, [...]

Value-based payment models may improve patient health by targeting quality of care over quantity of health services. Social workers in primary care settings are well-positioned to improve the quality of health services for vulnerable patients by identifying and addressing patients' social determinants of health. This case study describes a Plan Do Study Act (PDSA) quality improvement approach implemented and refined by social workers to proactively address clinical quality gaps in one family medicine practice. The studied program – entitled Gap Closure Day – was led by a team of social workers to improve quality outcomes of patients. Findings highlight the important roles of social workers as members of health care teams to improve the quality of health services and address health equity. [ABSTRACT FROM AUTHOR]

Social work has seen significant federal investment through the Behavioral Health Workforce Education and Training (BHWET) for Professionals grants. This research note examined differences between BHWET trainees and general MSW graduates regarding self-reported knowledge of integrated behavioral health competencies, job placement, and starting salaries. A survey was administered 10 months after graduation (N=288) for five graduating classes (2014-2018). Bivariate two-tailed t-tests and Fisher's exact tests examined group differences. BHWET participants rated interprofessional abilities and integrated care skills significantly higher; were significantly more likely to secure employment quicker; work on interprofessional teams; and earn higher salaries, compared to counterparts. Demonstrating the effectiveness of workforce initiatives is necessary to document best practices and continue federal investment in the social work workforce. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine how well Electronic Health Record (EHR) documentation identifies which health professionals act to address patient social determinants of health (SDOH) and what interventions are documented. The Electronic Medical Record Search Engine was used to identify food and housing insecurity EHR notes. From the notes, researchers randomly sampled 60 from each SDOH category. Of 120 notes, which contained a reference to food or housing insecurity, 72% also contained information on an intervention taken. Interventions were documented by social workers 63% of the time, followed by dietitians and physicians. Addressing patient SDOH is a crucial part of comprehensive healthcare. Findings contribute to a broader conversation on the documentation and interventions in healthcare settings to address patients' SDOH. Findings support the critical importance of standardizing SDOH documentation in the EHR across more members of the health workforce to ensure patient needs are met. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs), often defined as potentially traumatic experiences such as child maltreatment and household difficulties (e.g., caregiver substance misuse) that occur prior to age 18, are associated with poor health and psychiatric illness across the life span and have been increasingly used as a predictor of health outcomes in both research and practice. However, limited research has explored who should be reporting ACEs for children or to what extent reporters agree on observations of ACE exposure. This study examines respondent agreement among children, caregiver, and caseworker using data drawn from the National Survey of Child and Adolescent Well-being (NSCAW II), a longitudinal, nationally representative survey of children who have been the subject of a child welfare investigation. A sub-sample of participants aged 8–17 was used (n = 1,652). The following ACE indicators had responses from all three respondents: sexual victimization, physical abuse, emotional abuse, and home violence. Analyses were completed to understand patterns of reporter's responses to each of the ACEs selected using sampling weights. We calculated interrater agreement using the Kappa coefficient for each ACE indicator. Children, caregivers, and caseworkers differentially reported the number of ACEs the child experienced. Children reported experiencing just over two ACEs on average, while caregivers reported two and caseworkers reported an average of one. Overall, Kappa coefficients were extremely low with caseworker-caregiver agreement the highest at.41. Given the lack of concordance, we recommend asking multiple informants while carefully considering self-report by children when assessing for ACEs. [ABSTRACT FROM AUTHOR]

Exposure to childhood victimization and adversity (CVA) is pervasive for child welfare (CW) involved youth. However, most research with CW samples has focused on types of maltreatment and fails to recognize the additive influence of exposure to CVA beyond maltreatment. A subsample aged 8 to 17 (n = 1,887) was drawn from the National Survey of Child and Adolescent Well-Being (NSCAW) II. CVA included six domains. Behavioral health was assessed using the Child Depression Inventory, Trauma Symptom Checklist, and the internalizing and externalizing subscales of the Child Behavior Checklist. Logistic regression was used to explore the association between the number of CVA reported and the risk of clinical-range behavioral health symptoms. Analyses were adjusted for the cluster-based sampling design and sampling weights were applied to provide nationally representative estimates. More than 60% of the sample experienced three or more CVA domains. The number of CVAs reported was associated with all four behavioral health outcomes (p <.001). Children exposed to five or more domains were more likely to report high depressive symptoms (odds ratio [OR] = 5.0), high trauma symptoms (OR = 7.0), and to have internalizing or externalizing symptoms reported by caregivers (OR = 18.0), as compared with children reporting one or less CVAs. Youth involved with CW are exposed to staggeringly high rates of CVA beyond maltreatment. For children who are already at great risk for behavioral health challenges, research to understand screening and interventions for CVA is needed to inform policy and practice initiatives to prevent and mitigate harm. [ABSTRACT FROM AUTHOR]

Purpose: To identify the strategies and interventions U.S. health systems implemented to reduce burnout and increase employee well-being during the first year of the COVID-19 pandemic. Methods: A concurrent design included a scoping review of published literature on burnout interventions implemented for healthcare workers during COVID-19 and expert interviews with healthcare administrators involved in COVID-19 burnout response efforts (N = 5). Scoping review protocols included a-priori inclusion criteria, search terms, database selection, and data abstraction (N = 21 articles). Results: The scoping review identified eight types of interventions; spanning individual, organizational, and community systems. Qualitative data supported scoping review findings and uncovered themes related to communication, role shifting, and wellness initiatives as forms of burnout prevention and reduction. Conclusion: As COVID-19 continues, so too will worker stress, burden, and burnout. Health systems worked quickly and creatively to address the needs of the frontline healthcare workforce, yet more work is needed to sustain efforts over time. [ABSTRACT FROM AUTHOR]

Evidence shows that when an interprofessional (IP) approach is effectively implemented, it can counteract some of our most pressing health care problems. One such challenge is the lack of training in IP teamwork health care professionals receive during their education. Using a quasi-experimental matched comparison group design, this study assessed pre- and posttest changes in IP knowledge, attitudes, and skills of MSW students (N = 52) from 2015–2017, who received a specialized curriculum, and clinical internships working in IP teams, compared to an internal control group involving clinical IP teams alone. Two validated measures assessed changes in students' IP knowledge, values, and skills. Quantitative findings and qualitative responses to open-ended questions elucidate barriers and facilitative factors in IP teams. [ABSTRACT FROM AUTHOR]

This study examines the prevalence of trauma subtypes, polytraumatization, and perinatal depression (PND) in a diverse sample of adolescent mothers to help inform PND prevention, screening, and treatment efforts. We conducted a secondary analysis of a sample (N = 210) of adolescent mothers aged 14 to 20 years from a prospective longitudinal study of PND. Participants were recruited from a county-based, public health prenatal clinic, and data were collected in the prenatal and postpartum periods. In this sample, 81% of adolescent mothers reported at least one trauma experience and 75% reported lifetime experience of intimate partner violence (IPV). The most prevalent trauma types among adolescent mothers reporting PND were sexual trauma prior to age 13 (11.9%), loss of a caregiver or sibling (28.3%), emotional adversity (17.1%), and polytraumatization (43%). Trauma is alarmingly prevalent among adolescent mothers. Results suggest standards of care for adolescent mothers should include screening adolescent mothers for trauma history and provision of appropriate referrals for IPV. Findings support the need for trauma-informed treatment in perinatal public health clinics to decrease potential health risks to both mother and baby. [ABSTRACT FROM AUTHOR]