Behavioral Health and Care for Chronic Medical Conditions in Pennsylvania: The Role of the Medical Home

Principal Investigator: Karin Rhodes (Robert Wood Johnson Foundation Funded) 
Co-investigator:  Paul Crits-Christoph


The general aim of this project is to conduct quantitative analyses of Medicaid claims data in order to help the State of Pennsylvania make ongoing decisions about how best to reform healthcare. More specifically, our goal is to address the potential role of mental health and substance use treatment, in the context of a Medical Home model, for Medicaid patients who have chronic medical conditions and psychiatric or substance use disorders. The chronic medical conditions targeted will be diabetes, congestive heart failure, asthma, and COPD, the four most costly and common chronic medical conditions (PHC4, 2010). It is unclear whether a medical home model, or integrated behavioral/medical care model, leads to reduced healthcare utilization and costs. The proposed research will address these issues in a Pennsylvania Medicaid claims database for individuals with chronic medical conditions and comorbid psychiatric or substance use disorders.

Study Aims

  • To examine rates of current psychiatric and substance use disorders, among individuals with one of 4 chronic medical conditions, within the target practices and target Federally Qualified Health Centers (FQHCs), which will be compared to rates from available epidemiological samples matched by age, sex, race/ethnicity and geographic region.
  • To compare health care utilization and costs for patients treated in a Medical Home model vs. those not treated in a Medical Home model.
  • To compare health care utilization and costs for patients treated in a FQHC that included integrated behavioral health to patients treated in a matched FQHC that did not include integrated behavioral health.

AnRCTof brief intervention for problem drinking and partner violence (2010-2015)

Principal Investigator: Karin Rhodes (NIAAA Funded) 
Co-investigator:  Paul Crits-Christoph


Intimate partner violence (IPV) remains a major source of morbidity and mortality in the United States, with women suffering the majority of adverse long-term consequences. While both men and women perpetrate IPV at similar rates, this grant will focus on IPV-involved women drinkers (victims, perpetrators, or both), largely because of the lack of literature that addresses this population of women.

Evidence suggests that brief opportunistic interventions in the Emergency Department (ED) setting are effective in reducing subsequent hazardous drinking and alcohol-related injuries in men, but results have been less clear in women.

Study Design and Aims

The current study proposes a randomized controlled trial of 600 female ED patients who self-disclose co-occurring problem drinking and intimate partner violence. We will investigate whether a brief motivational intervention can decrease primary outcomes of episodes of heavy drinking and incidents of IPV by administering the Interactive Voice Response System weekly for 12 weeks. We will also explore likely mediators and moderators of the intervention.

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