The Rural Hawai'i Behavioral Health Program: Increasing access to primary care behavioral health for native Hawaiians in rural settings.

Health care access issues present significant challenges for rural populations and health providers. Psychology can support improved access and quality of rural health services through the development of integrated behavior health programs within primary care settings. This article reviews a clinical training and service delivery program, the Rural Hawai'i Behavioral Health Program, which has evolved in response to the pressing health needs of Native Hawaiians in rural communities. Native Hawaiian cultural factors and components of the primary care model that have supported the development of this program will be reviewed. Program expansion, sustainability, and treatment efficacy research will be discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child health psychology.

[Correction Notice: An erratum for this article was reported in Vol 9(6) of Health Psychology (see record 2008-09119-001). The name of the author, Sharon Millstein, should be Susan Millstein.] The term child health psychology refers to the field of research on the behavioral aspects of children's health and illness. At this time we need to continue the work of the child health psychology special interest group and to draw into the Division of Health Psychology a much larger number of developmental psychologists, who need to be informed about the relevance of their scientific training to child health issues. We call the Division's attention and that of granting agencies such as the National Institute of Child Health and Human Development to the following high-priority child health research issues: adherence to pediatric medical regimens; child health promotion; family influences on child and adolescent health and disease; and stress and coping in childhood illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and health.

This article traces the historical development of Canadian medicare and its significant influence on shaping not only the clinical services provided within Canada's public health care system but also its major impact on the nation's overall health research agenda. Particular emphasis is placed on how this has influenced the development and role of psychology in the public health care system. It is argued that all psychologists, whether their work is focused on the applied or experimental areas of the discipline, have much to offer Canadians across the entire health care spectrum. Nevertheless, psychological services in the public health care system, and particularly in hospitals, have mainly developed within and continue to be primarily focused around mental health. Services in nonmental health areas of health have been more limited, although their importance is well recognized. The current situation partly reflects the limited training in general health issues that clinical psychologists-in-training generally receive in many graduate school programs in Canada. However, it also reflects the overall influence of medicare on the development of Canada's health care system. Medicare has tended to focus the activities of Canada's health care system primarily on treating illness rather than on preventing it and/or maintaining health. Also, medicare has oriented Canada's health care system mainly toward delivering medical services rather than providing more comprehensive health services (e.g., the "medically necessary" criterion for funding). However, times are changing. The growing emphasis among health policymakers in Canada on illness prevention and health promotion (e.g., the creation of the federal government Public Health Agency of Canada in 2004) will significantly expand psychology's role across all areas of health. Psychology education and training programs are urged to seriously examine whether psychology practitioners and researchers are being adequately prepared at present for the much broader array of future interdisciplinary professional, research, and educational activities and responsibilities that will emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology can be indispensable to health care reform and the patient-centered medical home.

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March 2010, making health care reform a reality. Perhaps the most well-developed model of primary care that aligns with the PPACA's agenda is the patient-centered medical home (PCMH). Integrated care, as defined by collaborative care between mental health and primary care providers and systems, will undoubtedly play a critical role in the success of the PCMH. The role of psychology and integrated care in the PCMH as well as training implications for psychologists are discussed. This article is intended to challenge our discipline to embrace psychology as a health care profession that must prepare for and solidify its added value in the health care delivery models of the future. Requisite skill sets for primary care psychologists and existing training opportunities are presented. Finally, possible mechanisms for training psychologists in integrated care and the professional roles primary care psychologists can expect to fill are proposed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Commentary: Health care for the whole person.

This article summarizes the rationale for and history of Ronald F. Levant's 2005 American Psychological Association Presidential Initiative, "Health Care for the Whole Person," from which this special section originated. This initiative was intended to have both practice and policy implications in the application of the biopsychosocial model. The articles in this series present the rationale for and details of this integrated model in terms of research, economics, rural applications, and women's health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special section: Ecological momentary assessment in health psychology.

Health psychology, like most branches of behavioral science, relies heavily on self-report as a primary source of data. Because data obtained through self-report methods are typically unreliable, researchers have adopted a variety of methods, which have been labeled ecological momentary assessment, or the experience sampling method, for collecting moment-by-moment data in real-world settings. This article provides an introduction to a special section on ecological momentary assessment in health psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-centered culturally sensitive health care: Model testing and refinement.

Objectives: This article presents the results of an empirical test of a literature-based Patient-Centered Culturally Sensitive Health Care Model. The model was developed to explain and improve health care for ethnically diverse patients seen in community-based primary care clinics. Design: Samples of predominantly low-income African American (n = 110) and non-Hispanic White American (n = 119) patients were recruited to complete questionnaires about their perceived health care provider cultural sensitivity and adherence to their provider's treatment regimen recommendations. Main Outcome Measures: Patients completed written measures of their perceived provider cultural sensitivity, trust in provider, interpersonal control, satisfaction with their health care provider, physical stress, and adherence to provider-recommended treatment regimen variables (i.e., engagement in a health promoting lifestyle, and dietary and medication adherence). Results: Two-group path analyses revealed significant links between patient-perceived provider cultural sensitivity and adherence to provider treatment regimen recommendations, with some differences in associations emerging by race/ethnicity. Conclusion: The findings provide empirical support for the potential usefulness of the Patient-Centered Culturally Sensitive Health Care Model for explaining the linkage between the provision of patient-centered, culturally sensitive health care, and the health behaviors and outcomes of patients who experience such care. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

"Child health psychology": Erratum.

Reports an error in "Child health psychology" by Dennis Drotar, Suzanne Bennett Johnson, Ron Iannotti, Norman Krasnegor, Karen A. Matthews, Barbara G. Melamed, Sharon Millstein, Rolf A. Peterson, Debbie Popiel and Donald K. Routh (Health Psychology, 1989, Vol 8[6], 781-784). The name of the author, Sharon Millstein, should be Susan Millstein. It appears correctly in this record. (The following abstract of the original article appeared in record 2008-09118-001.) The term child health psychology refers to the field of research on the behavioral aspects of children's health and illness. At this time we need to continue the work of the child health psychology special interest group and to draw into the Division of Health Psychology a much larger number of developmental psychologists, who need to be informed about the relevance of their scientific training to child health issues. We call the Division's attention and that of granting agencies such as the National Institute of Child Health and Human Development to the following high-priority child health research issues: adherence to pediatric medical regimens; child health promotion; family influences on child and adolescent health and disease; and stress and coping in childhood illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investments in behavioral health services: Strengthening the safety net.

As the primary Federal agency at the U.S. Department of Health and Human Services for improving access to health care services to the medically, financially and geographically vulnerable, the Health Resources and Services Administration (HRSA) is committed to improving health outcomes and achieving health equity by funding access to quality services, a skilled health workforce, and innovative delivery programs. Furthermore, HRSA recognizes the importance of access to quality behavioral health services. This article describes HRSA's current efforts to address behavioral health needs within the safety net through the delivery of quality health services and a strengthened workforce. Also, it highlights HRSA's commitment to providing good quality mental health and substance abuse services through key federal and nonfederal partnerships. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Establishing an integrated care practice in a community health center.

In a progressively complex and fragmented health care system and in response to the need to provide whole-person, quality care to greater numbers of patients than ever before, primary care practices throughout the United States have turned their attention and efforts to integrating behavioral health into their standard service-delivery models. With few resources and little guidance, systems struggle to gather the support required to establish effective integrated programs. Based on first-hand experience, we describe a working integrated primary care model, currently utilized in a large community health center system in Colorado, that encompasses universal screening, consultation, psychotherapy, and psychological testing. With appreciation for the way an organization's unique circumstances inform the best approach for that particular organization, we highlight the clinical-level and system-level variables that we consider necessary for successful practice development and address how our behavioral health program operates despite funding limitations. We conclude that organizations that aim for integrated primary care must mobilize leadership to implement systemic changes while making difficult decisions about program development, financing, staffing, and interagency relationships. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Training Primary Care Psychologists: A Model for Predoctoral Programs.

This article focuses on blueprints for developing primary care psychology training in graduate psychology programs. The rationale and the foundations for establishing primary care psychology as a generalist model in clinical programs are identified. An outline of a core curriculum for multiprofessional training and an introductory knowledge base for primary care psychology is presented. Finally, a developmental model for primary care practicum training and supervision is described and exemplified. Funding issues, faculty development, and student evaluations of this training are discussed. This article represents the ever-evolving model and lessons learned through 10 years of experience in collaborative programs among Wright State University's School of Professional Psychology, the School of Medicine, the College of Nursing and Health, and a set of urban community health centers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training for the future of psychology practice.

This article responds to the Eby et al. (this issue, pp. 57–68) paper on issues and dilemmas for the future of training for psychology practice. The author addresses these issues and discusses them in regards to our identity as psychologists and changes in training needed in light of the recent passage of federal health care reform legislation. The changes in health care include the importance of training to work in integrated health care systems, primary care, using electronic health records, and dealing with health disparities. Training recommendations from the 2009 APA Presidential Task Force on the Future of Psychology Practice are presented. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Depression in ethnically diverse women: Implications for treatment in primary care settings.

What do health care practitioners need to know about providing adequate care for depressed minority women? This article examined the prevalence of depressive symptoms and clinical depression in ethnic minorities, the extent to which current health service utilization is congruent with needs, and the effectiveness of treatments provided to ethnic minorities in the primary care setting. The impact of ethnic minority women's sociocultural context on symptom expression and help-seeking behavior is also discussed. Finally, the clinical implications for accurate assessment and treatment of ethnic minority women by both medical and mental health practitioners working in the primary care sector are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Home birth and short-stay delivery. Lessons in health care financing for providers of health care for women

The current restructuring of the U.S. health care delivery system is driven primarily by economic forces. Although primary care providers may understand the roles of technology and advocacy in fostering fundamental change, they may not be familiar with the issues related to financing of health care and, thus, may not fully appreciate the extent to which economic factors influence the character of their professional lives and the services they provide. Analysis of the loss of the home birth option in the 1950s provides a method for understanding and influencing the factors driving health care restructuring today. In examining short-stay delivery in the 1990s, this article also addresses ways in which managed health care systems may improve or restrict women's access to a variety of primary care services.     

Review of The psychology of health and health care: A Canadian perspective.

Reviews the book, The psychology of health and health care: A Canadian perspective by Gary Poole, Deborah Hunt Matheson, and David N. Cox (2001). This book is a timely introductory text that aims to situate the rapidly expanding field of health psychology within the geographic, socio-demographic, and empirical landscape of Canada. This textbook would be appropriate for beginning and intermediate undergraduate students across a range of disciplines, including psychology, public health, and nursing. As such, it has a number of features to commend it. It is written in a clear and concise style, with explanatory tracks guiding the reader step by step through each new concept. In keeping with health psychology's applied focus, web sites for important resources are provided and sample case studies are integrated with key concepts throughout each chapter. Finally, the up-to-date coverage of Canadian health statistics and research publications is a delight for those of us who have been struggling to find texts that reflect the unique ways in which we view, structure, fund, administer, and research health psychology and health care in this country. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women's oral health issues: an exploration of the literature

As interest in women's health issues grows, there is increasing concern that today's practice of medicine may not meet the health needs of women. A primary reason is the gender bias that has been inherent in medical education, research and clinical practice. The prevailing medical viewpoint has often been that the male body is considered to be the norm and that the female body exactly the same except for the reproductive function. This attitude has led to a lack of interest in researching gender differences and a consequent lack of knowledge of women's health issues. Fortunately, there is a movement for change. The Women's Health Interschool Curriculum Committee was formed in January 1992 to develop curricula concerning women's health and examine bias that may exist in existing curricula. The Canadian Women's Health Network has been growing across the country and there have been calls to create a new specialty in women's health. According to Angell, this proposal for a new specialty was provocatively debated in the Journal of Women's Health, which started publication in 1992. There is also a growing concern on how to conduct better research to address women's health needs. As more attention is paid to women's health issues, what will happen in the area of oral health? In health care, it would seem that the mouth has become completely separated from the rest of the body. Health conferences rarely have any oral health content at all. To correct this problem, there must be an increase in general awareness of the importance of oral health as it relates to the overall health of both women and men. Good oral health is more than just decay-free teeth. Oral health encompasses the teeth, the supporting periodontal structures, soft tissues of the mouth and oral pharynx area, temporomandibular joints and muscles of mastication. The mouth is a gateway to the body and will also reflect many systemic health problems, such as diabetes, leukemia and lupus. The second step would be the recognition that women may have different oral health needs and issues than men. The common view may be that teeth are gender free, but how can this be when teeth exist in a body, and that body is male or female? For many years, the primary acknowledged difference between men and women's oral health was pregnancy gingivitis. Like medicine, dentistry must re-examine the viewpoint that women's oral health differs from men's only as it is influenced by reproductive processes. There are many areas where women's oral health may differ from that of men. This paper will explore the literature for potential women's oral health issues in the areas of oral hygiene behaviours, esthetics, eating disorders, temporomandibular disorders, and hormonal influences on periodontal health.     

Migrant mental health: A model for indicators of mental health and health care consumption.

Objective: This study explores the relationship between mental health and health care consumption among migrants in the Netherlands. Design: Samples of the Turkish (n = 648), Moroccan (n = 102), and Surinamese (n = 311) populations in Amsterdam were examined. The study tested a hypothesized model of risk factors for psychiatric morbidity, indicators of well-being, and indicators of health care consumption. The model was specified on the basis of information from earlier research on the sample and literature on the topic. The model was tested and refined using structural equation modeling. Main outcome measures: Psychiatric morbidity and well-being measures were assessed with the CIDI 1.1 and MOS-sf-36 subscales, respectively. Health care consumption was assessed by the question "Have you ever consulted one or more of these professionals or health care facilities with respect to mental health problems or problems related to alcohol or drugs usage?" Results: The primary result of this study was the confirmation that health care consumption among migrants is predicted by need and predisposition factors, such as health condition and sociodemographic characteristics. In addition, mental health care consumption of migrants is predicted by acculturation characteristics. This result suggests an effect of cultural and migrant-specific factors in help-seeking behavior and barriers to mental health care facilities. Conclusions: Findings confirm the existence of migrant-specific mechanisms in health care consumption. Mental health care professionals should be aware of these. However, ignoring common ground for interventions unnecessarily creates distance between migrant groups and between migrant and indigenous Dutch groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling psychology in clinical health psychology: The impact of specialty perspective.

Not all clinical health psychologists are trained as clinical psychologists. A significant minority is trained and identifies as counseling psychologists. As a field, it is important to understand how the specialty-specific values, training context, scholarship, and parameters of practice of counseling psychology contribute to clinical health psychology. In this article, we (a) identify the core values and training context of counseling psychology, (b) review the scholarly history of clinical health psychology by counseling psychologists, (c) present the parameters of practice of clinical health psychology as identified from the extant counseling psychology literature, and (d) examine American Psychological Association membership status to investigate joint membership in the Division of Health Psychology and the Society of Counseling Psychology. Conclusions indicate that (a) an identifiable set of core values guides the training of counseling psychologists, (b) scholarly literature by counseling psychologists has contributed to the growth and development of clinical health psychology, and (c) parameters of practice reflect the specialty-specific perspective of counseling psychology. As professional psychology continues to grow as a health care profession, clinical health psychology will benefit from the knowledge, values, attitudes, competencies, and practice parameters of counseling psychology, and counseling psychology will benefit from recognizing what it brings to the practice of clinical health psychology. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Provision of mental health services in women's health centers

Women's health centers are often associated with a comprehensive model of health care that treats the "whole woman." Using data from a nationwide study of 467 women's health centers, we explored how the ideal of comprehensive care was implemented with respect to mental health services. Specifically, we examined the rates of screening and treatment for a subset of mental health and behavioral and social problems in women's health centers and the structural, staffing, philosophical, and patient factors associated with the provision of services. Across 12 services, the overall rates of provision ranged from 7.7% for screening for dementing disorders to 27.6% for smoking cessation counseling and treatment. In a series of logistic regressions, center type (primary care) and having a mental health staff person were consistently associated with service provision; other important variables were having a high percentage of women using the center as their usual source of care and having a belief in women-centered care. Findings indicate that the majority of women using women's health centers do not receive services in a comprehensive care environment that includes key mental health services.