California
| Colorado | Connecticut | Deleware
| District of Columbia | Georgia
| Illinois | Missouri | Nebraska
| New Mexico | New York | North
Carolina | Oklahoma | Pennsylvania
| Tennessee | Virginia | West
Virginia
California
D40 HP 00041975
Gilbert Newman, Ph.D.
Department of Field Placement
The Wright Institute
2728 Durant Avenue
Berkeley, California 94704
Tel: 510-841-9230, Ext. 110
E-mail: gnewman@wrightinst.edu
IHPTP allows
the Wright Institute, an APA accredited graduate program in Berkeley,
CA to expand education and training to students working in primary
care with under- and uninsured patients. Wright has offered limited
training at the Berkeley Primary Care (BPC) Access Clinic since
2004. BPC is one of 8 clinics operated by LifeLong Medical Care
(LMC), a federally designated community health center (Title III,
Section 330), providing health and social services to underserved
people of all ages in Alameda County, California. Currently, four
Wright trainees are placed at BPC, serving adult clients. The proposed
program will add 8 students and utilize two additional training/service
sites at LMC. IHPTP will expand services to children, adolescents,
families and the elderly. IHPTP promotes an integrated approach
to health services and access to physical and mental health care
for culturally diverse and disadvantaged consumers. IHPTP goals
are to: 1) improve care to LMC consumers; 2) prepare an emerging
psychology workforce to address the whole person through an integrated
mind/body approach to health; and 3) promote collaboration between
psychologists and other health services providers.
LMC consumers
are: 96% low-income, 40% medically uninsured, and 76% non-white.
Many consumers are homeless, unemployed or working poor, and regularly
experience hunger. LMC patients seek treatment for uncontrolled
chronic illnesses, such as diabetes, obesity, heart disease, chronic
pain, and HIV/AIDS. The primary unmet health need of this target
population is for psychological assessment and counseling for mental
health issues impacting overall health. The physicians at LMC clinics
are unprepared to address psychological issues that affect the health
of patients. Many patients suffer from stress, addiction, depression,
and other mental health disorders. IHPTP utilizes a collaborative
model pairing a psychology trainee in the examination room with
a physician. While the physician focuses on medical issues and physical
health, the trainee provides psychological services to patients.
Colorado
D40 HP 00041626
Deborah J. Seymour, Ph.D.
Psychiatry/Family Medicine
University of Colorado at Denver and Health Sciences Center
Mail Stop C268-71
4200 East Ninth Avenue
Aurora, Colorado 80045
Tel: 720-848-9094
E-mail: Deb.Seymour@uchsc.edu
The need for
psychologists to serve the underserved and to practice in medically
underserved communities has never been greater. The President’s
New Freedom Commission on Mental Heath (1999) stated that the mental
health system in the United States is broken and in need of transformation.
For many populations, access to mental health services in a primary
care setting is in itself a form of cultural competence because
it brings the services to a setting that is familiar and culturally
acceptable for many clients to whom a ‘mental health clinic’ is
culturally or personally unacceptable. The development of a cadre
of health services psychologists who have skills to work in primary
care and other health services settings is essential to the transformation
that is needed in our health care system.
The objectives
of this proposal are to prepare psychology interns to practice in
health care settings, particularly primary care health settings,
where underserved, minority and other disadvantaged populations
seek health and mental health care services. We currently have 7
interns working in 7 different major rotation sites. In 2007-2008
we will have 4 interns working in 4 sites. We will add 2 new health
care major rotation sites for the 2008-2009 academic year. The key
elements of our work will include a focus on training all of our
psychology interns about our nation’s primary care health system,
providing the interns with experience in the skills needed to practice
in health services settings and training the interns to provide
services to a large number of underserved populations including
developmentally disabled children, newly arrived refugees, uninsured
and monolingual Spanish speaking Latino populations, migrant farm
workers, Native Americans, deaf individuals, and incarcerated individuals.
There are two
key areas of need that this grant addresses. Serving the underserved
and training health services psychologists. We will build the relationships,
capacity and curriculum to add new training experiences in a primary
care geriatrics clinic, a rural Colorado primary care health clinic
and a Federally Qualified Health Center that serves migrant farm
workers, Latinos and refugees. Education about special populations,
health systems, cultural competence and health disparities will
be completed and evaluated by program participants. We will also
create an innovative training program in which psychology interns
and third year medical students train side by side in rural and
inner city primary care health settings. Written materials suitable
for publication and presentations for public consumption will be
generated in order to report upon our successes and lessons learned
in the process of building this program. Evaluation of the effectiveness
of the curriculum and its impact on work site selection of program
completers will be made.
Connecticut
D40 HP 00041983
Michele Goyette-Ewing, Ph.D.
Child Study Center/School of Medicine
Yale University
230 South Frontage Road
P.O. Box 207900
New Haven, Connecticut 06520
Tel: 203-785-2017
E-mail: Michele.Goyette-Ewing@yale.edu
The current
project will continue to expand and evaluate a model for developing
leaders in the field of child psychology through providing graduate
interns in psychology with interdisciplinary training experiences
that target specific underserved populations and that increase the
integration of health care services by creating linkages between
health professionals functioning within a variety of programs and
agencies. This project will enhance and expand training opportunities
currently offered to psychology interns completing an American Psychological
Association (APA) approved internship at the Yale Child Study Center.
Collaborative training opportunities for psychology interns involve
physicians completing a child psychiatry residency program and social
workers completing a post-masters degree fellowship. In addition,
psychology fellows actively engage in work with underserved children
and youth through collaboration and consultation with a variety
of other professionals in the community, including primary care
physicians, emergency room personnel, pediatricians, school psychologists,
child psychiatrists, nurses, teachers, state child welfare case
workers, police officers, detention center workers, juvenile probation
officers, and social workers.
The project
seeks to continue to develop and enhance a newly created training
model, by providing clinical and didactic training experiences which
allow interns to work with underserved populations across a range
of areas. Training experiences emphasize gaining expertise in Specialty
Training areas, while participating in a generalist curriculum of
psychological assessment, intervention, consultation, professional
development, and research. These experiences increase access to
clinical services and address the needs of underserved populations,
including:
- Children
exposed to violence
- Children
affected by HIV/AIDS
- Children
with serious psychiatric illness
- Children
with significant developmental disabilities
- Children
with school-related problems
- Children
diagnosed with serious physical illness
Four psychology
interns participate in the proposed project during each training
year. Each intern has an individualized course of study that incorporates
didactic and clinical experiences. Interns are based at the Yale
Child Study Center, but engage in multi-agency and multi-disciplinary
collaborations through linkages with hospital and community based
initiatives. These experiences are designed to increase the workforce
of culturally competent psychologists who can effectively work with,
and teach others to work with, medically underserved populations.
Delaware
D40HP00043574
William Douglas Tynan, Jr., Ph.D.
Department of Pediatrics/Behavioral Health
Alfred I. duPont Institute/Hospital for Children, NCC - Wilmington
1600 Rockland Road 1H-11A
Wilmington, Delaware 19803
Tel: 302-651-4552
E-mail: dtynan@nemours.org
The Nemours
Graduate Psychology Education Program proposed here will include
training psychology residents to provide screening and implementation
of evidence based treatments in primary care settings and child
development centers, along with increased training for pediatric
residents and advanced practice nurses and community mental health
professionals in developmental and behavioral screening and interventions.
The model provides a seamless transition from one level of care
to another, via the integrated pediatric medicine and psychological
services in primary care settings that have been established in
medically underserved areas of the state of Delaware.
The proposed
program builds on the success of the prior HRSA grants, by incorporating
geriatric knowledge into the curriculum, specifically the issues
of parenting faced by grandparents; genetic knowledge and ethics
particularly pertaining to Attention Deficit Hyperactive Disorder
(ADHD); and utilizing distance learning methodologies to improve
access to continuing education in population based healthcare.
This proposal also provides innovations in the training program
through creative use of the Electronic Medical Record (EMR), a unique
strength of Nemours; and by increasing the number of psychology
teaching experiences for residents, including teaching pre-doctoral
health professions students and community-based providers.
The proposed
project will train 15 health service psychologists over a three-year
period. The training provided will utilize an integrated model
of pediatric mental and physical health, will primarily serve African
American and Hispanic, Medicaid eligible children residing in an
area that is designated as having a shortage of health care professionals
and or designated as a medically underserved area. The program
will include completion of the Nemours Pediatric Primary Behavioral
Care Modules, as well as six months of supervised clinical experience
in primary care settings.
The project
will also train 66 pediatric residents and 3 nurse practitioner
interns who will complete the Nemours Pediatric Primary Behavioral
Care Modules over a three year period, as well as participate in
the Behavior Consultation Clinic for four sessions or consult with
faculty psychologists on cases seen in continuity pediatric clinic.
Additionally,
the project provides cultural competence training for all participants
specific to the two primary cultural groups served, and uses distance-learning
methodologies to increase the access to such training.
Nemours request
special considerations for this collaborative proposal across pediatrics,
nursing and psychology; additionally the project qualifies for the
Medically Underserved Community Funding Preference demonstrating
“High Rate” and “Significant Increase”(see MUC Preference Request
Table).
District
of Columbia
D40 HP 00041967
Dominicus W. So, Ph.D.
Psychology/ Graduate School of Arts and Sciences
Howard University
CB Powell Building, Room N-279
525 Bryant Street, NW.
Washington, D.C. 20059
Tel: 202-806-9462
E-mail: dso@howard.edu
Needs.
Howard fulfills the Healthy People 2010 National Goals to
increase quality and years of healthy life, to increase a diverse
populations’ access to culturally competent healthcare, and to eliminate
health disparities among minorities. We seek to reduce Blacks’ disproportionately
high rates of mental illnesses, and increase their utilization of
mental health services. In DC, Blacks are the largest ethnic group;
19.3% of its residents and 33% of people under 18 were in poverty
in 1997. As much as 1/8 of the population were uninsured in 2000.
Howard Unive rsity Hospital is the only historically black university
hospital serving the poor. Without the GPEP, we cannot bring well-trained
African Americans into the health workforce.
Current
trainees. Howard currently has 35 clinical psychology doctoral
students and 3 interns.
Service
goals and training objectives. Our training in integrated
care occurs primarily at 5 hospitals/clinics: Howard University
Hospital, Holy Cross Hospital, Kennedy Krieger Institute, Children’s
National Medical Center, and the People’s Community Wellness Center
(a church-run clinic), where trainees provide bio-psychosocial evaluations,
psychotherapy, behavioral consultations, treatment, and prevention
programs targeting hypertension, tobacco and substance use, sexual
risk-taking, child and maternal health, and medical compliance.
We attempt to:
- Improve
quality of care by (a) evidence-based, best and emerging practices;
(b) training students to use culture as a positive force in change;
(c) using biopsychosocial assessments; and (d) translating cutting
edge research into useful strategies to deal with stress and adversities.
- Improve
health care delivery by supporting the workforce and service infrastructure.
Our current grant afforded us critical infrastructure including
competent health psychology supervisors, student stipends, supplies,
a health psychology conference for area faculty and students,
and improved curriculum and placements.
- Eliminate
health barriers by maintaining the supply and diversity of health
workforce. As the oldest and most prestigious of the HBCUs
offering a Ph.D. in clinical psychology, our clinical program
has graduated nearly
100 students, 95% of whom are people of color or engage in eliminating
health disparities. With the proposed grant, we can train 38 enrolled
minority graduate students and graduate 18 underrepresented minority
Ph.D.s. during the proposed training period.
- Reduce
health disparities by employing a full range of healthcare skills
and services to populations with disproportionate share of disease
and disability.
Target
populations. Virtually all our students go on to treat the
underserved: the uninsured, children, women, the incarcerated, and
people of color with dire medical and mental health needs.
Georgia
D40 HP 00043571
Paul Alexander Mabe, Ph.D.
School of Medicine/Psychiatry and Health Behavior
Medical College of Georgia
1515 Pope Avenue
Augusta, Georgia 30912
Tel: 706-721-8812
E-mail: amabe@mail.mcg.edu
This proposal
represents a competing continuation application for the MCG-VAMC
Consortium Psychology Workforce Development Project (D40 HP00012-02-00).
Data indicate that Georgia is a state with significant mental health
problems and an inadequate mental health workforce to address these
problems. Access to psychologists is particularly limited with Georgia
ranking 48th among states in psychologists per capita.
Moreover, Georgia is disproportionately low in regard to its psychology
workforce development with less than 1 percent of the total internship
positions available nationally in a state that ranks 9th
in overall population. The three-fold purpose of this project has
been to: (1) Enhance the efforts of the MCG-VAMC Psychology
Residency Consortium in producing professional and racially/ethnically
diverse psychologists who are well prepared for and seek out careers
that are directed toward integrated approaches to health care issues,
who have experience with and interest in serving in mental health
and medically underserved areas, who are well prepared to stay abreast
if not lead the way in the development of evidence-based practices
in the field of mental health care, and who aspire to cultural competence
in their practice; and (2) Expand the capability of the Consortium
to recruit and train residents in the mental health care delivery
to children and to individuals living with HIV/AIDS-two populations
of significant need and limited mental health resources in Georgia.
(3) Refine and extend our training in dealing with the special
mental health needs of women in health care settings- another population
in Georgia that has significant and unmet needs. The project’s efforts
have been extensively and uniformly successful, providing broad
interdisciplinary training experiences for psychology residents,
developing innovative interdisciplinary training/service programs,
publishing and nationally presenting the outcomes of these interdisciplinary
training efforts, providing clinical services and outreach educational
programs for underserved populations in Georgia, and placing a high
percentage of program completers in interdisciplinary health care
settings that serve underserved populations. At present there are
7 psychology enrollees in the program and the target for the proposed
project is to maintain a comparable number of enrollees in the next
three years. This project now endeavors to build on these efforts
by partnering with Project GREAT (Georgia Recovery-Based Educational
Approach to Treatment funded by the Georgia Department of Human
Resources), to immerse psychology and psychiatry faculty and residents
in the Recovery model of mental health care. Endorsed in 2003 by
President Bush’s New Freedom Commission, the Recovery model emphasizes
patient freedom and choice in care and facilitates patients and
family members in functioning in advisory, teaching, and care-giving
roles. This proposed project will endeavor to not only develop Recovery
knowledge, skills, and attitudes in our interdisciplinary faculty
and trainees but also to incorporate them in a state-wide dissemination
project that will target mental health professionals in local and
outlying rural counties of Georgia.
Illinois
D40 HP 00041965
Maureen Ann Lacy, Ph.D.
Department of Psychiatry
Biological Sciences Division
The University of Chicago
5841 S. Maryland Avenue, MC 3077
Chicago, Illinois 60637
Tel: 773-834-3930
E-mail: mLacy@yoda.bsd.uchicago.edu
The University
of Chicago is located in the South Side of Chicago, a designated
underserved mental health area, with a predominantly older, African
American population. The purpose of this grant is to develop, operate
and maintain a multidisciplinary training program at The University
of Chicago that focuses on the goal of developing health service
psychologists who will work with underserved populations. In order
to achieve this goal, faculty from psychology, psychiatry, geriatrics,
and social work will work collaboratively to integrate and focus
the curriculum and broaden the training sites to community centers,
in order to meet the needs of the underserved African American patient
population within our community. Psychology students will train
along side trainees from geriatrics, psychiatry, social work, and
neurology. The ultimate goal of this program is to eliminate barriers
to care and ultimately eliminate health provider disparities for
African Americans.
Missouri
D40 HP 00043579
Terri L. Weaver, Ph.D.
Department of Psychology
College of Arts and Sciences
Saint Louis University
221 North Grand Boulevard
St. Louis, Missouri 63103
Tel: 314-977-2198
E-mail: weavert@sLu.edu
Intimate partner
violence (IPV) is a significant, albeit underreported and under
identified, public health problem. The proposed project extends
and enhances a 4-year-old funded program entitled, Pediatric-Psychology
Partnership for Abuse Prevention (PPP-AP, http://www.pediatricpsychologypartnership.com).
PPP-AP uses culturally competent psychology trainee-pediatric
resident and medical trainee pairs to assess for IPV and intervene
with underserved women presenting with their children for pediatric
care. Pediatric-Psychology Partnership for Dating Violence Prevention
would extend IPV assessment and intervention to adolescent patients.
The project would train clinical psychology/pediatric trainees to
assess for and intervene in adolescent dating violence, utilizing
adolescent-specific assessment and intervention materials, and provide
these services within University Pediatrics, an ambulatory healthcare
setting with a history of successful pediatric-psychology collaboration.
The proposed enhancement would reduce issues of health disparity
in dating violence by eliminating barriers to care for underserved
African American adolescents and by increasing the number of ethnic
minority students trained. Five psychology trainees and four pediatric
residents would receive in-depth training while 16 pediatric residents
and 50 medical students would receive exposure to the project each
year. Improved access to care will be achieved by providing assessment
and intervention within a standard health care visit. Providing
services in this way also encourages trainees of both disciplines
to conceptualize, assess, and treat their patients using a framework
that emphasizes the inter-relatedness between mental and physical
health. A training compact disc (CD) would be developed to reflect
interdisciplinary training challenges and successes and with the
CD the training process would be exported to other national training
programs. Missouri, as a state and Saint Louis City, as a city,
is characterized by some of the highest rankings in health disparities
for minority’s health in the country. University Pediatrics has
a high representation of young, urban-dwelling, low-income adolescents,
seeing 2,462 teens between the ages of 12 and 18 each year.
Nebraska
D40 HP 00042013
Joseph Henry Evans, Ph.D.
Munroe-Meyer Institute/Department of Psychology
Board of Regents/University of Nebraska Medical Center
985450 Nebraska Medical Center
Omaha, Nebraska 68198
Tel: 402-559-6408
E-mail: jevans@unmc.edu
This GPE grant
application is designed to address the critical shortage of psychologists
treating children, adolescents and families in underserved rural
communities. Increasing the numbers of behavioral health providers
in rural underserved areas will be accomplished through an expansion
of the psychology internship training program located in the Psychology
Department of the Munroe-Meyer Institute at the University of Nebraska
Medical Center (UNMC). This “integrated behavioral health internship
model” has been created at UNMC and provides:
a) interdisciplinary
training experiences in serving children and adolescents with
disabilities and their families, and b) integrated “learning through
service” clinical experiences in rural primary care settings.
To date, the integrated behavioral health education model has
trained, placed, and retained program graduates in primary care
rural practices in Columbus, Hastings, Chadron, Gordon, Kearney,
Lexington, Crawford, Crete, Nebraska City, and Valley, Nebraska.
With continued funding from the Graduate Psychology Education
Program, the behavioral health model will be extended to a minimum
of three additional rural sites over the next three years with
the goal of providing internship training and placement of interns
into integrated behavioral health practices in underserved Health
Professions Shortage Areas. This project will provide training
for 18 psychology interns (12 with stipends supported partially
from GPB funding), 12 pediatric and family medicine residents,
and 20 mid-level mental health practitioner (counseling, marriage
and family, and social work) students through supervised interdisciplinary
training experiences in rural underserved areas. Interns will
be trained through experiences in interdisciplinary approaches
to working with children with disabilities and in methods to effectively
provide behavioral care services in rural primary care settings.
It is projected that a minimum of 50% of trainees will be attracted
to integrated primary care practice with the majority of these
providing behavioral health care in rural underserved (HPSA) locations.
New
Mexico
D40 HP 00041977
Eve Adams, Ph.D.
Department of Counseling and Educational Psychology
The Regents of New Mexico State University
MSC 3CEP, Box 30001
Las Cruces, New Mexico 88003
Tel: 505-646-1142
E-mail: eadams@nmsu.edu
The purpose
of the NMSU project is to increase the number of trainees in the
disciplines of counseling psychology (CP), social work (MSW), and
family medicine (FM) who provide integrative, comprehensive primary
care in medically underserved committees (MUCs). This goal will
be obtained by creating coursework and practical experiences in
which trainees from these three disciplines learn about and work
collaborative with underserved populations in New Mexico. This collaborative
project will involve the APA accredited Ph.D. Program in CP at New
Mexico State University (NMSU), the MSW Program at NMSU, and the
Southern New Mexico FM Residency Program, located in Las Cruces.
Collaborative
training will occur in two contexts. MSW and CP students will take
a 3-credit, Interdisciplinary Seminar on US-Mexico Border Health
Issues (MPH 563) that uses a problem-based approach to case
study analysis designed to instill a broader appreciation of health
issues and multidisciplinary collaboration. This course will be
co-taught by faculty from all the disciplines. During this experience
the MSW and CP students will begin providing services at the FM
residency clinic (FMC). In the next semester the students will increase
their involvement at the FMC in addition to providing services at
other community-based health organizations as part of a practicum
titled, “Behavioral Health Practicum”.
This experience
will increase the likelihood that trainees will develop an interest
in working with underserved and diverse populations, will believe
they have the ability to work with this population, and will want
to continue to work with underserved groups during internship and
beyond. Program completers of the NMSU project will be better prepared
to provide culturally competent, multidisciplinary, integrated health
care to residents living in MUCs.
Objectives:
1) To increase the number of counseling psychologists (6 students/year
= 18 total), social workers (6 students/year = 18 total), and family
practice physicians (5-6 residents/year for 3 year residency = 28
total) trained to provide integrated health care to underserved
populations in medically underserved areas, particularly along the
US-Mexico border. 2) To train students’ in culturally appropriate
practices. 3) To enhance trainees’ self-efficacy regarding their
assessment, intervention and consultation skills in multidisciplinary
primary care settings. 4) To provide training in bilingual
counseling to CP and MSW trainees. 5) To assess patients on patient
variables related to utilization of health services.
New
York
D40 HP 00041870
Carmen Rivera, Ph.D.
Mental Health/Psychology Unit
Luthern Medical Center
150 55th Street
Brooklyn, New York 11220
Tel: 718-437-5218
E-mail: crivera@Lmcmc.com
The Lutheran
Family Health Center Network, as one of the nation’s largest federally
qualified health centers, seeks to expand its APA-accredited Psychology
Internship program into the primary care setting in a manner which
sets as its goals the Healthy People 2010 goals of increasing life
span and quality of life, and of elimination of health disparities.
The proposed project is aimed at increasing access to culturally
competent services for the underserved, largely ethnic minority
populations to the medically underserved communities in the areas
served by the Lutheran Family Health Centers. Significant disparities
exist in the service area related to chronic and acute medical conditions
such as asthma, diabetes, obesity, cancer, and HIV/AIDS as well
as the psychological distress associated with these conditions which
negatively impact the disease process. Behavioral health interventions
can be utilized to increase compliance, improve outcomes, and help
consumers live healthier lives. The services area’s health disparities
are compounded by psychosocial impediments such as stigma, the uninsured,
and lack of access to services. The program proposes to develop
an interdisciplinary curriculum from the fields of psychology, social
work, and medicine to create a collaborative environment among professional
staff and provide continuous services to consumers who might otherwise
not have access. The curriculum trains psychology interns alongside
social work interns, who will be working alongside medical professionals,
and will include didactic and experiential components such as direct
patient care, consultation, case presentation, and seminar. Interventions
will include assessment, short-term individual and group psychotherapy,
psycho-education, and consultation. The curriculum will increase
the program completers understanding of the medical conditions facing
consumers and the challenges inherent in providing community-based
medical services as well as educating medical staff about behavioral
health symptoms and interventions which may aid in the management
of disease. The program philosophy will be guided by a sensitivity
to the multicultural needs of the population served and incorporate
direct service and consultative approaches. The proposed program
will also create two new clinical rotations emphasizing knowledge
and practice in the prevention of disease and health promotion.
The program seeks to disseminate the curriculum as a model program
aimed at increasing the number of psychologists and social workers
choosing primary care, community-based prevention and health promotion
services in underserved areas and to link psychological, social,
and medical practice and education. The psychology internship has
the capacity for seven pre-doctoral psychology interns, has been
in existence for 19 years and has been continuously accredited by
the American Psychological Association since 1994 with its current
accreditation extending to 2011. A Licensed Psychologist will be
recruited and retained as the Project Coordinator and will be responsible
for coordinating all of the administrative and clinical activities
of the program as well as providing supervision to the interns.
Lutheran Family Health Center’s resources for implementing this
program are vast, and are detailed within the Project narrative.
Our record of support to develop and sustain culturally sensitive
training and clinical programs is longstanding, and also noted in
the narrative.
D40 HP 00042071
Linda Jayne Alpert-Gillis, Ph.D.
Department of Psychiatry
University of Rochester Medical Center
300 Crittenden Boulevard
Rochester, New York 14642
Tel: 585-275-3610
E-mail: Linda_AlpertGillis@urmc.rochester.edu
The proposed
Graduate Psychology Education (GPE) program will provide postdoctoral
training with underserved child, adolescent, and family populations
within an interdisciplinary health care environment via linkages
throughout the University of Rochester Medical Center and the community.
The proposed program will train two Child and Adolescent Psychology
postdoctoral fellows per year for three years, six fellows total.
The program will enable trainees to develop expertise in innovative
models of mental health care delivery and preventive interventions
for underserved youth in both community and medical center-based
settings in order to achieve integrated health care approaches and
increased access to care. Special emphasis will be placed on integrating
mental health care into pediatric primary care settings, as well
as implementing public health initiatives in school settings. The
GPE program will eliminate barriers to care and health disparities
by: 1) training fellows in new models of care delivery to serve
diverse, medically underserved populations of children, adolescents,
and their families, and prepare fellows for careers with these populations;
and 2) increasing the number of underrepresented minority/disadvantaged
psychologists in this field, supporting their program completion,
and facilitating their transition to the workforce serving medically
underserved communities. The program will enhance our current GPE
program and build upon the strengths of our other training programs
by providing training opportunities with underserved populations
for psychology, pediatric, nursing, and child psychiatry
trainees.
Mental health,
psychosocial problems and risk-taking behaviors, many of which are
preventable, currently cause more morbidity and mortality in the
child and adolescent population than physical diseases and disorders.
National data indicate that mental health problems now affect 1
in 4 children in the U.S., and that there is a paucity of providers
currently available to address this need. Healthy People 2010 highlights
the need to improve mental health and ensure access to appropriate
quality mental health services.
The training
model is based on the adult learning and training literatures which
delineate three learning outcomes: knowledge, efficacy/attitudes,
and skill. The training objectives will be met through three modalities:
didactic seminars; practica involving direct service, consultation,
and program development in linkages with community-based and URMC-based
programs and settings; and scholarly projects. The project evaluation
meets two interrelated purposes: 1) to provide data internal to
the program to insure its quality and satisfactory trainee progress;
and 2) to provide HRSA data on the project’s outcomes and impact.
The evaluation plan ties explicitly to the project rationale, objectives,
and HRSA’s CPMS indicators. The evaluation has three primary components:
Evaluation of Trainees, Faculty, and Program.
The program
evaluation is designed to provide formative data, primary and secondary
outcome data, summative outcome data, project impact data, and to
facilitate continuous quality improvement.
North
Carolina
D40 HP 00041981
Susan Phillips Keane, Ph.D.
Department of Psychology
College of Arts and Sciences
University of North Carolina at Greensboro
P.O. Box 26170
Greensboro, North Carolina 27402
Tel: 336-256-0017
E-mail: spkeane@uncg.edu
This project
aims to address the growing need for culturally competent mental
health care professionals working with underserved populations.
The underserved populations targeted by this project include children
birth to five years of age, economically disadvantaged children
and families, and aging adults. Services to each of these groups
will be provided within the framework of cultural competence and
the interface of health and mental health care through collaboration
with local community agencies and health care providers. This project
has specific goals for service provision within each of the targeted
populations. Infants are disproportionately represented in the national
welfare system and early screening, prevention, and intervention
services for these children can have a significant impact on the
costs of later academic and behavioral problems. Children from economically
disadvantaged backgrounds frequently do not receive the mental health
services they need; this too may lead to increases in both academic
and behavioral difficulties. With a growing elderly population nation-wide,
it is imperative that the number of service providers trained to
offer care in illnesses such as dementia, Alzheimers, and depression
related to declining health and loss of functioning also increases.
This project will provide service to these three populations in
addition to closing the gap between physical and mental health care,
thus helping consumers access more necessary health services. In
addition to addressing immediate community needs through the provision
of these services, this project also seeks to enhance the scope
of training for graduate students in clinical psychology as well
as train students who are committed to providing services in underserved
populations upon program completion. Students will receive training
in issues related to working with the target populations of the
project through five seminar series on: 1) early intervention needs;
2) working with economically disadvantaged children; 3) the interface
of health and mental health; 4) geriatric training; and 5) psychotropic
medication training. These seminar series will be supplemented with
workshops and presentations designed to scaffold training in such
a way as to provide advanced students with necessary tools to engage
in practica experiences, while also exposing younger students to
a Systems of Care approach to service provision and increasing awareness
and appreciation for cultural differences among all students. This
scaffolding approach to training across the three years of funding
will ensure that training opportunities reach all 35 current trainees,
as well as 18 new students (6 per each year of the project). Project
goals and strategies will be shared on both local and national levels
in order to increase awareness of barriers to service experienced
by the target populations and provide a model for training and service
provision in other communities.
Oklahoma
D40 HP 00043502
Barbara Bonner, Ph.D.
Pediatrics/CCAN/College of Medicine
University of Oklahoma Health Sciences Center
1100 NE. 13th Street
Oklahoma City, Oklahoma 73117
Tel: 405-271-8858
E-mail: Barbara-Bonner@ouhsc.edu
The impact of
child maltreatment and trauma on children’s overall health and well-being
have been well documented in the literature (Bonner, Logue, Kaufman,
& Niec, 2001). The most disadvantaged and underserved groups
such as low income families, minorities, and culturally diverse
communities are at increased risk for such problems. It is vital
to increase access to care, provide integrated multidisciplinary
services, and address the mental health needs of maltreated and
traumatized children and their caregivers. The goal of the Interdisciplinary
Training Initiative for Underserved Children (ITIUC) is to improve
the health of abused or traumatized infants, children, and adolescents
by increasing psychology trainees’ knowledge, skills, and competencies
to work with these underserved groups of children through a discipline-specific
and interdisciplinary training program. The ITIUC will accomplish
the following five objectives: 1) provide integrated discipline-specific
and interdisciplinary education to psychology trainees that emphasizes
a multidisciplinary approach and integration of health, mental health,
legal, and social services to serve maltreated and traumatized children;
2) reduce health disparities and improve access to health care services
by increasing the number and diversity of trained psychologists;
3) advance the knowledge and skills, leadership, and professional
development of psychology trainees to assure the quality of care
and outcomes for underserved children; 4) promote the use of evidence-based
treatment approaches; and 5) promote clinically relevant research
to improve the outcomes for maltreated and traumatized children.
Psychology students will be trained to provide culturally competent,
integrated services to two groups of underserved children, victims
of child maltreatment and children exposed to trauma. The ITIUC
will be composed of two major components: (1) a discipline-specific
component focusing on the training of psychology students in the
assessment, treatment, and prevention of child maltreatment, and
(2) an interdisciplinary component in which psychology students
are trained with students from medicine, law, social work, dentistry,
nursing, and related disciplines in the medical, social, and legal
aspects of maltreatment. Psychology enrollees (N = 8) will be recruited
from three APA-approved graduate psychology programs in Oklahoma
(University of Oklahoma, Oklahoma State University, and the University
of Tulsa) and from the APA-approved internship and Postdoctoral
Fellowship programs at the University of Oklahoma Health Sciences
Center. The ITIUC psychology students will receive an annual
stipend, participate in the program for a minimum of one year, complete
all program requirements, and receive a certificate of program completion.
The program will be evaluated on an annual basis and the enrollees
will be followed for a minimum of five years to assess the impact
of the program.
Pennsylvania
D40 HP 00041639
Thomas J. Power, Ph.D.
Pediatrics / Child Development
Children’s Hospital of Philadelphia
Joseph Stokes, Jr. Research Institute
3615 Civic Center Boulevard
Philadelphia, Pennsylvania 19104
Tel: 215-590-7447
E-mail: power@email.chop.edu
This project
is designed to prepare trainees in psychology, child and adolescent
psychiatry, and developmental-behavioral pediatrics for careers
that will benefit medically underserved populations (MUPs), with
a particular focus on children with or at risk for disabilities
and chronic illnesses from racial/ethnic minority groups and low
socioeconomic status. Consistent with the mission of The Children’s
Hospital of Philadelphia (CHOP), the project is dedicated to the
preparation of leaders in providing clinical care and conducting
research that is directly related to practice. The project emphasizes
the preparation of professionals in the areas of cultural effectiveness
and public health. Further, the project is designed to develop strategies
to recruit and select trainees of underrepresented racial/ethnic
minority status. Each year, five Psychology Interns will be selected
for this project.
The following
are the goals of the project: (1) Improve the skills and competencies
of Psychology interns and trainees in Psychiatry and Developmental-Behavioral
Pediatrics in providing services to underserved populations, in
particular children with or at risk for disabilities and chronic
illnesses from underrepresented minority groups and low socioeconomic
status; (2) Improve the knowledge base of Psychology interns and
trainees in Psychiatry and Developmental-Behavioral Pediatrics in
the areas of cultural competence, public health, ethics, and genetics;
(3) Develop the infrastructure of the Psychology Training Program
to prepare leaders in service integration for MUPs; and (4) Select
interns in Psychology who have strong to exceptional background
in the areas of diversity awareness and cultural competence.
Interns will
obtain experiential training in one or more of the following community
rotations: (a) Violence Prevention, (b) Behavioral Health in Schools,
(c) Primary Care Intervention, (d) Adolescent HIV, (e) Starting
Young (for young children in foster care), (f) Management of ADHD
in Primary Care, and (g) Sickle Cell Disease Intervention. Each
of these programs provides services to children with or at risk
for disabilities/chronic illnesses, who reside in low-income families
located in inner-city communities. Over 90% of the children served
are members of racial/ethnic minority groups.
Didactic training
will be provided to trainees in psychology, child and adolescent
psychiatry, and developmental-behavioral pediatrics through a variety
of interdisciplinary training forums. Multiple strategies will be
used to recruit trainees who are committed to working with underserved
populations in community settings, which have been highly successful
in recruiting trainees from underrepresented racial and ethnic minority
groups.
Tennessee
D40 HP 00043503
Parinda Khatri, Ph.D.
Cherokee Health Systems
2018 Western Avenue
Knoxville, Tennessee 37921
Tel: 865-544-0406
E-mail: parinda.khatri@cherokeehealth.com
Cherokee Health
Systems (CHS) a Federally Qualified Health Center (FQHC) serving
11 counties in East Tennessee at 20 clinic sites, proposes to expand
its internship training class to four from three and increase the
level of multidisciplinary training for the internship program as
a whole. The overall purpose of the project is to increase the
trained workforce in integrated care while improving services for
underserved and disadvantaged populations in East Tennessee. The
CHS APA accredited predoctoral internship in psychology provides
generalist training that prepares students for the practice of professional
psychology in multidisciplinary community based settings. The primary
goal of the CHS internship is to provide an intensive and diverse
clinical training experience within a community health setting.
Because CHS provides progressive and broad-based health services,
interns gain exposure to a unique range of clinical training opportunities,
with a primary focus on integrated primary behavioral care. The
variety of clinical experiences within a community health setting
facilitates professional competency in a range of arenas, including
Clinical Skills, Integrated Services Delivery, Sensitivity to Individual
and Cultural Diversity in Professional Work, Ethical Standards in
Clinical Practice, and Professional Development. The additional
intern will be placed in Cherokee Health System’s newest clinic
in inner city Knoxville, serving a predominantly African-American
community. This clinic (Center City clinic) provides medical and
behavioral outpatient services to the community at large. The Center
City clinic multidisciplinary staff includes internal medicine physicians,
pediatricians, psychiatrists, psychiatric nurse practitioners, a
physical therapist, family nurse practitioners, pharmacists, psychologists,
and clinical social workers. They work in unison to provided comprehensive,
integrated health care to patients with complex medical, social,
and mental health needs.
CHS partnered
with the Knox County Health Department in early 2007 to provide
primary care services to the city’s most indigent population, primarily
homeless or in shelters. The Knox County Health Department is also
located in an inner city Knoxville urban area and employs a contingent
of primary care providers and other medical providers and ancillary
staff. One hundred percent of the Health Department’s patients
are uninsured and many are indigent or homeless. Both the CHS and
the Health Department census tracts are federally designated Medically
Underserved Communities. With the Knox County Health Department
collaboration, beginning April 2007, CHS Center City clinic will
provide primary care services to an additional 1500 patients. This
partnership and the ability to have an additional intern present
an opportunity to expand psychology training in primary care with
an underserved population.
Virginia
D40 HP 00041872
Barbara Ann Cubic, Ph.D.
Departments of Psychiatry and Behavioral Sciences
Eastern Virginia Med ical School
825 Fairfax Avenue P.O. Box 1980
Norfolk, Virginia 23507
Tel: 757-446-5888
E-mail: cubicba@evms.edu
Recent trends
in health care combined with society’s stigmatization of mental
health patients have lead to patients receiving mental health care
most frequently in primary care settings. Unfortunately, on-site
interdisciplinary training in dealing with behavioral issues in
primary care for psychology interns or family medicine residents
is rare. This remains true despite the fact that many of the main
focus areas of the
GP 2010 relate
to quality care access, behavioral change, mental health, and substance
abuse. Numerous barriers to appropriate primary care mental health
treatment exist that are related to misconceptions about mental
illness and mental health treatments held by patients. Uninformed
providers and the design of primary care visits (e.g. time constraints)
create additional barriers. A mechanism for addressing these barriers
is integrated training at the advanced level (i.e. internship, residency)
that creates an understanding of each disciplines different backgrounds,
values, professional models, and ideologies.
The proposed
project will fund an educational model that teaches psychology interns
about the subtleties of working in a primary care environment. Simultaneously
the mental health education of family medicine residents will be
fostered. Through minor rotations in primary care psychology, psychology
interns, will complete morning rounds with residents in the inpatient
setting, serve as consultants and educators for outpatient primary
care practices, and receive specialized training in cultural diversity,
obesity, geriatrics and child settings. Psychology interns will
also receive enhanced didactics on primary care psychology topics
and teach didactics to family medicine residents. The educational
model also has components that are on the cutting edge of new practices
seen in primary care settings as psychology interns will participate
in co-leading enhanced medical visits with family physicians. Lastly,
and in addition to the plan to enhance the training of psychology
interns, embedded in the proposal is a plan to also expand the cultural
competence of the faculty who provide training for the interns.
Concurrently, the family medicine residents will develop enhanced
skills at diagnosing and treating psychosocial issues within the
primary care setting.
The goals of
this grant coincide with the Bureau of Health Professions’ performance
goals (elimination of barriers to care and health disparities) and
HRSA’s desire to address key 21st century needs (training professionals
to address the interrelatedness of physical and mental health).
Training will occur in sites that provide services to a high percentage
of medically underserved patients from an urban area (estimated
at 81% African American, 2% Asian or Hispanic in the SNGH facility
and 62% African American, 2% Asian or Hispanic in the GFP facility).
These sites serve Health Professional Shortage Areas in primary
care (Low Income Downtown Portsmouth, South Norfolk, Suffolk) and
mental health (Low Income South Norfolk, Eastern Shore).
West
Virginia
D40 HP 00042002
Marianna Footo-Linz, Ph.D.
Department of Psychology
Marshall University
One John Marshall Drive
Huntington, West Virginia 25701
Tel: 304-696-2774
E-mail: Linz@marshall.edu
The Department
of Psychology at Marshall University has developed a unique program
to train doctoral level (Psy.D.) behavioral health professionals
who are sensitive to, and informed about, the cultural issues involved
in working with underserved rural populations. This emphasis is
built upon the tradition established by our affiliated medical school,
the Joan C. Edwards School of Medicine, which has become nationally
known for successfully training primary care physicians willing
to serve in rural and frontier communities. We propose the establishment
of an interdisciplinary, rurally focused training program that will
collaboratively integrate students in our clinical psychology doctoral
program and students enrolled in the Joan C. Edwards School of Medicine.
We anticipate that this program will have significant impact on
recruitment and retention of professionals who are well prepared
to meet the challenges of rural practice and who will ultimately
choose to provide culturally sensitive and effective services for
underserved populations. The impact of this program will be both
local and national in scope and has the potential to become self
sustaining in the future and also has significant potential for
future expansion in terms of adding additional disciplines (such
as dentistry).
Our accredited
Psy.D. program emphasizes components specifically designed to heighten
sensitivity to the unique milieu existing in communities that are
more isolated from mainstream culture. Through a combination of
coursework and supervised clinical experiences, students come to
understand that these culturally distinct community systems have
developed in response to the needs of the people who live there
day to day and should not be simplistically viewed through a deficiency
model. During their final practicum experience, students are placed
in rural multidisciplinary settings and receive training with pediatric
residents and medical students. During this
10 month clinical
practicum, students learn to combine consultative and community
oriented skills with traditional psychotherapy and assessment skills
in an integrated behavioral health model which enhances their effectiveness
as rural practitioners. The present proposal documents the significant
needs that exist in rural and underserved regions, particularly
those in central Appalachia, and describes the evidenced-based manner
in which the curriculum has been designed to prepare students to
practice in such areas.
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