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The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More

Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).

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11248 Results
9161
Stepped care in primary care - guided self-help and face-to-face cognitive behavioural therapy for common mental disorders: a randomized controlled trial
Type: Journal Article
Authors: Sigrid Salomonsson, Fredrik Santoft, Elin Lindsater, Kersti Ejeby, Brjann Ljotsson, Lars-Goran Ost, Martin Ingvar, Mats Lekander, Erik Hedman-Lagerlof
Year: 2018
Publication Place: England
Abstract:

BACKGROUND: Common mental disorders (CMD) cause large suffering and high societal costs. Cognitive behavioural therapy (CBT) can effectively treat CMD, but access to treatment is insufficient. Guided self-help (GSH) CBT, has shown effects comparable with face-to-face CBT. However, not all patients respond to GSH, and stepping up non-responders to face-to-face CBT, could yield larger response rates. The aim was to test a stepped care model for CMD in primary care by first evaluating the effects of GSH-CBT and secondly, for non-responders, evaluating the additional effect of face-to-face CBT. METHODS: Consecutive patients (N = 396) with a principal disorder of depression, anxiety, insomnia, adjustment or exhaustion disorder were included. In Step I, all patients received GSH-CBT. In Step II, non-responders were randomized to face-to-face CBT or continued GSH. The primary outcome was remission status, defined as a score below a pre-established cutoff on a validated disorder-specific scale. RESULTS: After GSH-CBT in Step I, 40% of patients were in remission. After Step II, 39% of patients following face-to-face CBT were in remission compared with 19% of patients after continued GSH (p = 0.004). Using this stepped care model required less than six therapy sessions per patient and led to an overall remission rate of 63%. CONCLUSIONS: Stepped care can be effective and resource-efficient to treat CMD in primary care, leading to high remission rates with limited therapist resources. Face-to-face CBT speeded up recovery compared with continued GSH. At follow-ups after 6 and 12 months, remission rates were similar in the two groups.

Topic(s):
Healthcare Disparities See topic collection
9162
Stepped Care Internet-Delivered vs Face-to-Face Cognitive-Behavior Therapy for Pediatric Obsessive-Compulsive Disorder: A Trial Protocol for a Randomized Noninferiority Trial
Type: Journal Article
Authors: Kristina Aspvall, Erik Andersson, Fabian Lenhard, Karin Melin, Lisa Norlin, Lena Wallin, Maria Silverberg-Mörse, Inna Feldman, Matteo Bottai, David Mataix-Cols, Eva Serlachius
Year: 2019
Publication Place: Chicago, Illinois
Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
,
HIT & Telehealth See topic collection
,
Measures See topic collection
9163
Stepped Care Interpersonal Psychotherapy Treatment for Depressed Adolescents: A Pilot Study in Pediatric Clinics
Type: Journal Article
Authors: L. Mufson, M. Rynn, P. Yanes-Lukin, T. H. Choo, K. Soren, E. Stewart, M. Wall
Year: 2018
Publication Place: United States
Abstract: Adolescents with depression are at risk for negative long-term consequences and recurrence of depression. Many do not receive nor access treatment, especially Latino youth. New treatment approaches are needed. This study examined the feasibility and acceptability of a stepped collaborative care treatment model (SCIPT-A) for adolescents with depression utilizing interpersonal psychotherapy for adolescents (IPT-A) and antidepressant medication (if needed) compared to Enhanced Treatment as Usual (E-TAU) in urban pediatric primary care clinics serving primarily Latino youth. Results suggest the SCIPT-A model is feasible, acceptable and potentially beneficial for urban Latino adolescents. Clinicians delivered the SCIPT-A model with fidelity using supervision successfully implemented in a community setting.
Topic(s):
Healthcare Disparities See topic collection
9164
Stepped Care Interpersonal Psychotherapy Treatment for Depressed Adolescents: A Pilot Study in Pediatric Clinics
Type: Journal Article
Authors: L. Mufson, M. Rynn, P. Yanes-Lukin, T. H. Choo, K. Soren, E. Stewart, M. Wall
Year: 2018
Publication Place: United States
Abstract: Adolescents with depression are at risk for negative long-term consequences and recurrence of depression. Many do not receive nor access treatment, especially Latino youth. New treatment approaches are needed. This study examined the feasibility and acceptability of a stepped collaborative care treatment model (SCIPT-A) for adolescents with depression utilizing interpersonal psychotherapy for adolescents (IPT-A) and antidepressant medication (if needed) compared to Enhanced Treatment as Usual (E-TAU) in urban pediatric primary care clinics serving primarily Latino youth. Results suggest the SCIPT-A model is feasible, acceptable and potentially beneficial for urban Latino adolescents. Clinicians delivered the SCIPT-A model with fidelity using supervision successfully implemented in a community setting.
Topic(s):
Healthcare Disparities See topic collection
9165
Stepped care mental health service in Australian primary care: codesign and feasibility study
Type: Journal Article
Authors: J. Anderson, K. O'Moore, M. Faraj, J. Proudfoot
Year: 2019
Publication Place: Australia
Abstract: ObjectiveIn 2015, the Australian Government introduced several mental health reforms, including the requirement that Primary Health Networks (PHNs) provide stepped care services for Australians with mental health needs such as anxiety and depression. This paper reports on the development and feasibility study of StepCare, an online stepped mental healthcare service in general practice that screens patients, provides immediate feedback to patients and general practitioners (GPs), transmits stepped treatment recommendations to GPs and monitors patients' progress, including notification of deterioration.MethodsThe present codesign and feasibility study in one PHN examined: (1) the acceptability and feasibility of StepCare to GPs, practice staff and patients; (2) the impact of StepCare on clinical practice; and (3) the barriers to and facilitators of implementation.ResultsThirty-two GPs, 22 practice staff and 418 patients participated in the study. Overall, patients, practice staff and GPs found StepCare acceptable and feasible, commending its privacy, the mental health screening, monitoring and feedback. They also made suggestions for service improvements. GPs reported that StepCare helped with their identification and management of patients with common mental health issues.ConclusionsPreliminary data suggest that StepCare may be acceptable and feasible in Australian general practice, helping GPs identify and manage common mental health problems in their patients. The study provides implications for policy and practice, and points the way to future translational research into stepped mental health care.What is known about the topic?Depression and anxiety are common illnesses in primary care and GPs are ideally placed to implement stepped care approaches enabling early detection and accessible, effective care.What does this paper add?Developed in and for general practice, StepCare is the first fully integrated stepped approach to primary mental health care in Australia. As a first step in a translational research program evaluating the effectiveness of StepCare, this paper reports data regarding the feasibility and acceptability of the service.What are the implications for practitioners?Integrated into the workflow of general practice, StepCare is an online service that helps GPs detect new cases of depression and anxiety, provide evidence-based stepped care treatments and monitor patients' progress.
Topic(s):
General Literature See topic collection
9166
Stepped care mental health service in Australian primary care: codesign and feasibility study
Type: Journal Article
Authors: J. Anderson, K. O'Moore, M. Faraj, J. Proudfoot
Year: 2019
Publication Place: Australia
Abstract: ObjectiveIn 2015, the Australian Government introduced several mental health reforms, including the requirement that Primary Health Networks (PHNs) provide stepped care services for Australians with mental health needs such as anxiety and depression. This paper reports on the development and feasibility study of StepCare, an online stepped mental healthcare service in general practice that screens patients, provides immediate feedback to patients and general practitioners (GPs), transmits stepped treatment recommendations to GPs and monitors patients' progress, including notification of deterioration.MethodsThe present codesign and feasibility study in one PHN examined: (1) the acceptability and feasibility of StepCare to GPs, practice staff and patients; (2) the impact of StepCare on clinical practice; and (3) the barriers to and facilitators of implementation.ResultsThirty-two GPs, 22 practice staff and 418 patients participated in the study. Overall, patients, practice staff and GPs found StepCare acceptable and feasible, commending its privacy, the mental health screening, monitoring and feedback. They also made suggestions for service improvements. GPs reported that StepCare helped with their identification and management of patients with common mental health issues.ConclusionsPreliminary data suggest that StepCare may be acceptable and feasible in Australian general practice, helping GPs identify and manage common mental health problems in their patients. The study provides implications for policy and practice, and points the way to future translational research into stepped mental health care.What is known about the topic?Depression and anxiety are common illnesses in primary care and GPs are ideally placed to implement stepped care approaches enabling early detection and accessible, effective care.What does this paper add?Developed in and for general practice, StepCare is the first fully integrated stepped approach to primary mental health care in Australia. As a first step in a translational research program evaluating the effectiveness of StepCare, this paper reports data regarding the feasibility and acceptability of the service.What are the implications for practitioners?Integrated into the workflow of general practice, StepCare is an online service that helps GPs detect new cases of depression and anxiety, provide evidence-based stepped care treatments and monitor patients' progress.
Topic(s):
General Literature See topic collection
9167
Stepped care mental health service in Australian primary care: codesign and feasibility study
Type: Journal Article
Authors: J. Anderson, K. O Moore, M. Faraj, J. Proudfoot
Year: 2020
Publication Place: Australia
Abstract:

Objective In 2015, the Australian Government introduced several mental health reforms, including the requirement that Primary Health Networks (PHNs) provide stepped care services for Australians with mental health needs such as anxiety and depression. This paper reports on the development and feasibility study of StepCare, an online stepped mental healthcare service in general practice that screens patients, provides immediate feedback to patients and general practitioners (GPs), transmits stepped treatment recommendations to GPs and monitors patients' progress, including notification of deterioration. Methods The present codesign and feasibility study in one PHN examined: (1) the acceptability and feasibility of StepCare to GPs, practice staff and patients; (2) the impact of StepCare on clinical practice; and (3) the barriers to and facilitators of implementation. Results Thirty-two GPs, 22 practice staff and 418 patients participated in the study. Overall, patients, practice staff and GPs found StepCare acceptable and feasible, commending its privacy, the mental health screening, monitoring and feedback. They also made suggestions for service improvements. GPs reported that StepCare helped with their identification and management of patients with common mental health issues. Conclusions Preliminary data suggest that StepCare may be acceptable and feasible in Australian general practice, helping GPs identify and manage common mental health problems in their patients. The study provides implications for policy and practice, and points the way to future translational research into stepped mental health care. What is known about the topic? Depression and anxiety are common illnesses in primary care and GPs are ideally placed to implement stepped care approaches enabling early detection and accessible, effective care. What does this paper add? Developed in and for general practice, StepCare is the first fully integrated stepped approach to primary mental health care in Australia. As a first step in a translational research program evaluating the effectiveness of StepCare, this paper reports data regarding the feasibility and acceptability of the service. What are the implications for practitioners? Integrated into the workflow of general practice, StepCare is an online service that helps GPs detect new cases of depression and anxiety, provide evidence-based stepped care treatments and monitor patients' progress.

Topic(s):
Education & Workforce See topic collection
,
HIT & Telehealth See topic collection
9168
Stepped care: a method to deliver increased access to psychological therapies
Type: Journal Article
Authors: D. A. Richards
Year: 2012
Publication Place: Canada
Abstract: OBJECTIVE: To introduce stepped care as a method of organizing the delivery of treatments, and to consider the factors necessary for implementation. METHOD: Stepped care is described within the context of strategies such as collaborative care that aim to increase access to mental health care through the improved coordination of care between primary and specialist mental health services. Results from the implementation of stepped care in the United Kingdom and elsewhere are used to highlight the factors required for introducing stepped care into routine services. Issues to address when implementing high-volume services for common mental health problems are derived from this experience. RESULTS: Stepped care sits within the continuum of organizational systems, from situations where responsibility rests almost entirely with primary care clinicians to systems where all patients are managed by specialists for the entire duration of their treatment. Its core principles of delivering low-burden treatments first, followed by careful patient progress monitoring to step patients up to more intensive treatment, are easy to articulate but lead to considerable implementation diversity when services attempt to work in this manner. Services need to ensure they have specific staff competency training, including skills in delivering evidence-based treatments, access to telephony, and smart patient management informatics systems. CONCLUSIONS: Stepped care can provide the delivery system for supported self-management. To be successful, health systems need high levels of clinical outcome data and appropriately trained workers. Further attention is required to ensure equity of access and to reduce patient attrition in these systems.
Topic(s):
Education & Workforce See topic collection
,
HIT & Telehealth See topic collection
9169
Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial
Type: Journal Article
Authors: W. Katon, M. Von Korff, E. Lin, G. Simon, E. Walker, J. Unutzer, T. Bush, J. Russo, E. Ludman
Year: 1999
Topic(s):
General Literature See topic collection
9170
Stepped collaborative depression care: primary care results before and after implementation of a stepped collaborative depression programme
Type: Journal Article
Authors: L. G. Gidding, M. G. Spigt, G. J. Dinant
Year: 2014
Publication Place: England
Abstract: BACKGROUND: Numerous intensive research projects to assess the effects of stepped collaborative care (SCC) for depressed patients have been reported in primary care, yet it is unclear how SCC is sustained in usual care. OBJECTIVE: To assess how SCC for depression is actually being used and how it performs in usual primary care by studying medical data that are routinely collected in family practice, outside the research setting. METHODS: Retrospective before and after comparison of electronic medical records (EMR) regarding the implementation of an SCC depression programme in a large primary care organization from 2003 to 2012. Depression care parameters included prevalences, minimal interventions, Beck Depression Inventory-2 (BDI-2), antidepressants, referrals to psychologists and psychiatrists and primary health care consumption. RESULTS: After programme implementation, differentiation between levels of depression severity increased, more patients were treated with minimal interventions and more patients were monitored with BDI-2. These effects occurred in both nonseverely and severely depressed patients, although they were larger for patients registered as nonseverely depressed. Antidepressant prescription rates and referral rates seemed not to have been influenced by the SCC programme. Health care consumption of the depressed patients increased significantly. CONCLUSIONS: The depression care parameters changed to a different extent and at a different pace than after previous implementation initiatives. Future research should identify whether SCC uptake in primary care is best enhanced by intensive external guidance or by making care providers themselves responsible for the implementation. Analyses of EMR can be valuable in monitoring the implementation effects, especially after research projects are completed.
Topic(s):
Education & Workforce See topic collection
,
HIT & Telehealth See topic collection
9171
Stepped psychological intervention with common mental disorders in primary care
Type: Journal Article
Authors: Julio Cesar Martin García-Sancho, Ascensión Garriga Puerto, Carmen Egea, Gonzalo Díaz, Josefa Campillo Cáscales, Rosa María Espinosa Gil
Year: 2018
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
9172
Stepped‐care treatment of anxiety and depression in older adults: A narrative review
Type: Journal Article
Authors: Denise Meuldijk, Viviana M. Wuthrich
Year: 2019
Publication Place: Richmond
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
9173
Stepped, Collaborative, Coordinated Care for Somatic Symptom and Related Disorders (Sofu-Net): A Mixed-Methods Evaluation Among Health Care Professionals
Type: Journal Article
Authors: Meike Shedden-Mora, Amina Kuby, Justus Tönnies, Katharina Piontek, Bernd Lowe
Year: 2020
Publication Place: Boston, Massachusetts
Topic(s):
Education & Workforce See topic collection
,
Medically Unexplained Symptoms See topic collection
9174
Stepped, collaborative, coordinated care for somatoform disorders (Sofu-Net) - A mixed-methods evaluation among health care professionals
Type: Journal Article
Authors: MC Shedden-Mora, A. Kuby, K. Piontek, B. Lowe
Year: 2018
Publication Place: London
Topic(s):
Education & Workforce See topic collection
,
Measures See topic collection
,
Medically Unexplained Symptoms See topic collection
9175
Stepping up to stepped care
Type: Journal Article
Authors: Khrista Boylan
Year: 2019
Publication Place: Ottawa, <Blank>
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
9176
Steps Physicians Report Taking to Reduce Diversion of Buprenorphine
Type: Journal Article
Authors: Amy Yang, Cynthia L. Arfken, Chris-Ellyn Johanson
Year: 2013
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
9177
Steps towards a digital health ecosystem
Type: Journal Article
Authors: L. D. Serbanati, F. L. Ricci, G. Mercurio, A. Vasilateanu
Year: 2011
Publication Place: United States
Topic(s):
HIT & Telehealth See topic collection
9178
Stewarding Recovery from the Opioid Crisis Through Health System Initiatives
Type: Journal Article
Authors: Jeanmarie Perrone, Scott G. Weiner, Lewis S. Nelson
Year: 2019
Publication Place: Orange, California
Topic(s):
Opioids & Substance Use See topic collection
9179
STFM collaborates withPAEA to promote interprofessional education
Type: Journal Article
Authors: T. Nolte
Year: 2012
Topic(s):
Education & Workforce See topic collection
9180
Stigma and attitudes toward working in integrated care: Integrated care workforce issue brief #1
Type: Report
Authors: K. W. Linkins, J. J. Byra, G. Bess, J. Meyers, S. Goldberg, A. Dall
Year: 2013
Topic(s):
Education & Workforce See topic collection
,
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.