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Seattle-Denver Center of Innovation (COIN)

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COIN Investigators & Staff

COIN Investigators

 

John Fortney, PhD
Title:Core Investigator; Co-Director, VA Advanced Fellowship Program in HSR; Dissemination & Implementation Methodologist
Professor, Department of Psychiatry, Division Director - Population Health, University of Washington
Contact: John.Fortney@va.gov
Location: Seattle
University of Washington webpage
See Dr. Fortney's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
I conduct pragmatic trials and implementation trials to test the effectiveness of clinical interventions and the success of strategies designed to promote the uptake of evidence-based practices. My research focuses on rural health disparities, access to care, and the integration of mental health care and primary care.
I chose this work because I believe access to high quality healthcare is a basic right.
I hope to help overcome health disparities by using virtual technologies to improve access to effective mental health care.

Research Interests


Access to care for rural Veterans is the north star of Dr. John Fortney's work. Approximately 40% of Veterans diagnosed with PTSD live in rural America. Rural veterans are more likely to be older (55-74), unemployed, have more service-related disabilities, and have less education than urban veterans. Transportation is also a significant barrier for rural Veterans. Finally, there are fewer clinics offering specialty mental health services. And being seen going to a mental health clinic may bring public and personal stigma.

Access to evidence-based mental health treatments for rural veterans is essential. VA addresses access issues by increasing the number of primary care clinics providing mental health services. There is less stigma to being seen going into a primary care clinic. Providing mental health services in primary care clinics increases availability and reduces stigma.

A second approach to improving rural Veterans' access is using technology and providing evidence-based mental health services using virtual care platforms. The VA promotes media such as interactive video and text chatting. Many apps are available that provide Veterans and caregivers with increased access to services. The VA App Store is a handy resource.

A future area of research is the impact of monitoring patients' mental health symptoms when they're not in the clinic. The evidence-based practice is called measurement-based care. Mental health providers miss that their patient's problems are getting worse only about half the time. It is only slightly better when the patient is improving. Mostly, the patient is holding steady and doing OK. But when a patient gives a short self-assessment before meeting with the provider, change can be seen. Provider and patient can then see a difference in behaviors or feelings and make new decisions.

Dr. Fortney's work in access to care includes:

Comparing Two Telehealth Approaches for Treating Complex Psychiatric Disorders in Primary Care -- The SPIRIT Study
The SPIRIT Study compared two telehealth approaches for patients with complex mental health conditions who received care at rural clinics. Federally Qualified Health Centers, or FQHCs, are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions, such as posttraumatic stress disorder (PTSD) and bipolar disorder.
Visit: Comparing Two Telehealth Approaches for Treating Complex Psychiatric Disorders in Primary Care -- The SPIRIT Study
Comparing Primary Care Treatment Options for People with PTSD
In this current study, the research team compares PTSD treatment with antidepressants to written exposure therapy. In written exposure therapy, a therapist helps patients write about a traumatic memory to help lessen their PTSD symptoms. Results may help patients and primary care providers when considering ways to treat PTSD.
Learn more and follow results: Comparing Primary Care Treatment Options for People with PTSD
VA launches telehealth program for rural Vets with PTSD
The VHA Office of Rural Health, in partnership with the VHA Quality Enhancement Research Initiative, has deployed the Telemedicine Outreach for PTSD (TOP) program. The program includes 12 CBOCs across six VA medical centers. Veterans who use those CBOCs face considerable travel time and this telehealth program addresses this issue.
Read: VA launches telehealth program for rural Vets with PTSD
VA Research Career Scientist
The goal is to improve rural Veteran's access to and VHA's capacity to deliver evidence based mental health practices through mentoring, leadership, research, and implementation.
Learn more about Dr. Fortney's VA Research Career Scientist grant

The following images visualize Dr. Fortney's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):

Dr. Fortney's publication titles indicate primary work is Veteran care
Word cloud from pub titles
Dr. Fortney's collaborations are primarily from the University of Washington
Research collaboration map
The following research fields have been used to summarize Dr. Fortney's publications and grants.
Publications Grants
Clinical Research Clinical Research
Mental Health Health Services
Health Services Rural Health
Behavioral and Social Science Behavioral and Social Science
Brain Disorders Mental Health
Depression Brain Disorders
Clinical Trials and Supportive Activities Clinical Trials and Supportive Activities
Rural Health Prevention
Post-Traumatic Stress Disorder (PTSD) Comparative Effectiveness Research
Prevention Substance Abuse

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Grants

Research Career Scientist Award


VHA cares for almost 3 million Veterans living in rural areas, comprising 32% of all enrollees. Mental health disorders represent one of the most significant sources of disability among Veterans, including rural Veterans. Among OEF/OIF/OND Veterans enrolled in VHA, 57% have been diagnosed with a mental health disorder since 2002.
In 2010, 64% of VHA enrollees received primary care services at a Community-Based Outpatient Clinic (CBOC). However, evidence-based mental health practices developed for large VA Medical Centers (VAMCs) are often not feasible to deploy in small rural CBOCs. They thus are not accessible to large numbers of rural Veterans.
The lack of access to specialty mental health services and the limited capacity of the specialty mental health service line within VHA contribute to poor engagement in care and less than optimal mental health outcomes for rural Veterans.
Virtual care technologies can improve access to and engagement in care for rural Veterans and leverage scarce mental health resources to increase capacity. By increasing access and capacity, VHA can reach a more significant proportion of patients in need and maximize its population-level health impact.
OBJECTIVE(S):
Aim 1 - Mentor graduate students, post-doctoral fellows, and junior faculty members in order to cultivate the next generation of researchers with the content and methodological expertise needed to maximize VHA's population health impact on rural Veteran enrollees.
Aim 2 - Provide scientific leadership to our HSR Center of Innovation and QUERI Programs, and facilitate collaboration with our university affiliates, clinical programs, and operational partners in order maximize VHA's population health impact on rural Veteran enrollees.
Aim 3 - Conduct policy relevant, clinically actionable, and methodologically rigorous research to maximize VHA's population health impact on rural Veteran enrollees.
Funder: Veterans Affairs
VA HSR website

Advanced Fellowship in VA Health Systems Research and Development

Role: Multiple Principal Investigators
Funder: Veterans Affairs, Office of Academic Affiliations (OAA)

Comparing Primary Care Treatment Options for People with PTSD

Posttraumatic stress disorder, or PTSD, is a mental health problem that can occur after a traumatic event. People with PTSD may have bad dreams or scary thoughts.
Patients often receive treatment for PTSD in mental health clinics. But this type of care can be expensive, and it isn’t always available near where patients live. One option is for patients with PTSD to get treatment in primary care settings. For example, primary care doctors can prescribe medicine. Therapists who share space in a primary care clinic could provide talk therapy. But questions remain about the best ways to treat PTSD in primary care settings, especially for patients who don’t improve after the first treatment.
In this study, the research team is comparing PTSD treatment with antidepressants to written exposure therapy. In written exposure therapy, a therapist helps patients write about a traumatic memory to help lessen their PTSD symptoms. The team is also comparing three treatment sequences:
— Treatment starts with medicine. Patients who don’t feel better after four months receive written exposure therapy along with the medicine.
— Treatment starts with medicine. Patients who don’t feel better after four months switch to a different medicine.
— Treatment starts with written exposure therapy. Patients who don’t feel better after four months switch to medicine.
Results may help patients and primary care providers when considering ways to treat PTSD.
PCORI website

Virtual Care QUERI Program: Implementation of Technology Facilitated Evidence Based Practices to Improve Access to High Quality Care for Rural Veterans

The impact goal of the proposed VC QUERI is to support our operational partners in the regional and national rollout of evidence-based practices that incorporate virtual care technologies to improve access to high-quality care for rural Veterans in underperforming CBOCs.
Our operational partners are the Office of Rural Health, the Office of Connected Care, and the Office of Mental Health and Suicide Prevention. The evidence-based practices are Measurement-Based Care and Written Exposure Therapy for PTSD. The VC QUERI program will have an Implementation Core with 1) Implementation Team, 2) Qualitative Summative Evaluation Team, 3) Quantitative Summative Evaluation Team, 4) Economic Evaluation Team, and 5) Administrative Team.
The VC QUERI will also have a Rapid Evaluation and a Mentoring Core. A Veterans Engagement Panel and a Technical Expert Panel will guide the VC QUERI.
Funder: Veterans Affairs
NIH website

Collaborating to Heal Addiction and Mental Health in Primary care (CHAMP)

Role: PI
The proposed study will determine whether clinics implementing Collaborative Care with support from the University of Washington’s Advancing Integrated Mental Health Solutions Center can successfully treat mental health disorders and opioid use disorders concurrently in primary care settings.
Funder: National Institute of Mental Health
NIH website
Publications of note:
Integrating Routine Screening for Opioid Use Disorder into Primary Care Settings: Experiences from a National Cohort of Clinics
Potential for Precision Medicine in Methadone Treatment of Opioid Use Disorder

Measuring the Value of Improving Access to Community Care

Role: Co-I; PI: Edwin Wong
This study aims to develop innovative econometric methods for measuring the value of provider options from the perspective of Veterans.
The proposed research is timely and policy-relevant in light of the Commission on Care’s top long-term recommendation for transforming VHA through establishing community care networks for Veterans to access high-quality care.
Findings from this study will help inform VA’s rapidly evolving role as a payer. Specifically, developing value measures and identifying provider attributes that significantly increase value to Veterans will help VA assess the adequacy of community care networks and select contract providers to meet Veterans’ health care needs most effectively.
The strategic selection of high-quality provider options available through the Veterans Choice Program and future community care policies are attractive to key operational partners, including the Office of Community Care.
Funder: Veterans Administration
NIH website

Comparing Two Approaches to Provide Complex Mental Health Care for Patients in Rural Areas -- The SPIRIT Study

Federally Qualified Health Centers, or FQHCs, are community clinics providing primary care in rural and underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions, such as posttraumatic stress disorder (PTSD) and bipolar disorder.
In this study, the research team compared two telehealth approaches for patients with complex mental health conditions who received care at rural clinics. Telehealth is a way to provide care to patients remotely using phone or video calls. The two approaches were:
Telepsychiatry collaborative care, or TCC. In TCC, patients met with care managers in person or by phone. Care managers taught patients about their mental health, checked their symptoms, and provided therapy. Care managers also met with off-site mental health doctors weekly to review and adjust patients’ treatment plans. Primary care doctors prescribed all medicines for mental health.
Telepsychiatry-enhanced referral, or TER. In TER, patients had video calls with an off-site therapist or mental health doctor at their clinic. Remote therapists provided therapy. Remote doctors prescribed medicine to patients who needed it. TER required more time from therapists and mental health doctors than TCC.
In both approaches, patients first had a video call with a mental health doctor to develop a treatment plan.
After one year, patients in both TCC and TER reported that their quality of life, mental health symptoms, and side effects had greatly improved. Patients in TCC and TER didn’t differ in reports of: Quality of life, Severity of mental health symptoms, Satisfaction with care, Access to care, Medicine side effects. Patients also didn’t differ in sticking with their mental health medicines.
PCORI website

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Recent Publications

 

2024

Fortney JC, Kaysen DL, Engel CC, Cerimele JM, Nolan JP Jr, Chase E, Blanchard BE, Hauge S, Bechtel J, Moore DL, Taylor A, Acierno R, Nagel N, Sripada RK, Painter JT, DeBeer BB, Bluett E, Teo AR, Morland LA, Heagerty PJ. Sequenced treatment effectiveness for posttraumatic stress (STEPS) trial: A protocol for a pragmatic comparative effectiveness trial with baseline results. Contemp Clin Trials. 2024 Jun 10:107606. doi: 10.1016/j.cct.2024.107606. Epub ahead of print.
PMID: 38866094
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Blanchard BE, Bluett EJ, Johnson M, Zimberoff A, Fortney JC. Trauma exposure correlates among patients receiving care in federally qualified health centers. J Trauma Stress. 2024 May 14. doi: 10.1002/jts.23055. Epub ahead of print.
PMID: 38743483.
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Higashi RT, Etingen B, Richardson E, Palmer J, Zocchi MS, Bixler FR, Smith B, McMahon N, Frisbee KL, Fortney JC, Turvey C, Evans J, Hogan TP. Veteran Experiences With an mHealth App to Support Measurement-Based Mental Health Care: Results From a Mixed Methods Evaluation. JMIR Ment Health. 2024 May 10;11:e54007. doi: 10.2196/54007.
PMID: 38728684.
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Fortney JC, Curran GM, Lyon AR, Check DK, Flum DR. Similarities and Differences Between Pragmatic Trials and Hybrid Effectiveness-Implementation Trials. J Gen Intern Med. 2024 Apr 16. doi: 10.1007/s11606-024-08747-1. Epub ahead of print.
PMID: 38627320.
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2023

Pyne JM, Kelly PA, Fischer EP, Owen RR, Cucciare MA, Miller CJ, Connolly SL, Zamora KA, Koenig CJ, Seal KH, Fortney JC. Trust and perceived mental health access: Exploring the relationship between perceived access barriers and veteran-reported trust. Psychol Serv. 2023 Dec 21. doi: 10.1037/ser0000829. Epub ahead of print.
PMID: 38127502.
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Locke ER, Thomas RM, Simpson TL, Fortney JC, Battaglia C, Trivedi RB, Gylys-Colwell J, Swenson ER, Edelman JD, Fan VS. Cognitive and Emotional Responses to COPD Exacerbations and Patterns of Care Seeking. Ann Am Thorac Soc. 2023 Nov 15. doi: 10.1513/AnnalsATS.202303-287OC. Epub ahead of print.
PMID: 37966313.
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Cerimele JM, Franta G, Blanchard BE, Leasure W, Fortney JC. Bipolar disorder symptom monitoring measures: a mixed methods study of patient preferences. J Acad Consult Liaison Psychiatry. 2023 Nov 13:S2667-2960(23)00427-5. doi: 10.1016/j.jaclp.2023.11.266. Epub ahead of print.
PMID: 37967752.
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Carlo AD, Sterling RA, Mao J, Fiorella RP, Fortney JC, Unützer J, Wong ES. Characteristics of Veterans With Depression Who Use the Veterans Choice Program of the Veterans Health Administration. Psychiatr Serv. 2023 Nov 7:appips202100731. doi: 10.1176/appi.ps.202100731. Epub ahead of print.
PMID: 37933135.
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Moldestad M, Petrova VV, Tirtanadi K, Mishra SR, Rajan S, Sayre G, Fortney JC, Reisinger HS. Improving the Usability of Written Exposure Therapy for Therapists in the Department of Veterans Affairs Telemental Health: Formative Study Using Qualitative and User-Centered Design Methods. JMIR Form Res. 2023 Nov 6;7:e47189. doi: 10.2196/47189.
PMID: 37930747
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Cerimele JM, Fortney JC. Bipolar disorder assessment and monitoring measures in clinical care: Updates from a large randomized controlled trial in primary care. Bipolar Disord. 2023 Nov 3. doi: 10.1111/bdi.13382. Epub ahead of print.
PMID: 37923395.
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Fortney JC, Ratzliff AD, Blanchard BE, Johnson M, Ferro L, Austin EJ, Williams EC, Duncan MH, Merrill JO, Thomas J, Kitay B, Schoenbaum M, Heagerty PJ, Saxon AJ. Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis? Ann Intern Med. 2023 Oct;176(10):1431-1433. doi: 10.7326/M23-1369.
PMID: 37844317
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Blanchard BE, Johnson M, Campbell SB, Reed DE 2nd, Chen S, Heagerty PJ, Marx BP, Kaysen D, Fortney JC. Minimal important difference metrics and test-retest reliability of the PTSD Checklist for DSM-5 with a primary care sample. J Trauma Stress. 2023 Oct 16. doi: 10.1002/jts.22975. Epub ahead of print.
PMID: 37845820
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Austin EJ, Chen J, Briggs ES, Ferro L, Barry P, Heald A, Merrill JO, Curran GM, Saxon AJ, Fortney JC, Ratzliff AD, Williams EC. Integrating Opioid Use Disorder Treatment Into Primary Care Settings. JAMA Netw Open. 2023 Aug 1;6(8):e2328627. doi: 10.1001/jamanetworkopen.2023.28627. PMCID: PMC10422185.
PMID: 37566414
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Fortney JC, Rajan S, Chen JA, Campbell SB, Nolan JP, Wong E, Sayre G, Petrova V, Simons CE, Reisinger HS, Schnurr PP. A mixed-methods evaluation of why an implementation trial failed to engage veterans with posttraumatic stress disorder in trauma-focused psychotherapy. J Trauma Stress. 2023 Jun 27. doi: 10.1002/jts.22946. Epub ahead of print.
PMID: 37370238
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McGuier EA, Aarons GA, Wright JD, Fortney JC, Powell BJ, Rothenberger SD, Weingart LR, Miller E, Kolko DJ. Team-focused implementation strategies to improve implementation of mental health screening and referral in rural Children's Advocacy Centers: study protocol for a pilot cluster randomized hybrid type 2 trial. Implement Sci Commun. 2023 May 26;4(1):58. doi: 10.1186/s43058-023-00437-z. PMCID: PMC10214641.
PMID: 37237302
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Glass JE, Dorsey CN, Beatty T, Bobb JF, Wong ES, Palazzo L, King D, Mogk J, Stefanik-Guizlo K, Idu A, Key D, Fortney JC, Thomas R, McWethy AG, Caldeiro RM, Bradley KA. Study protocol for a factorial-randomized controlled trial evaluating the implementation, costs, effectiveness, and sustainment of digital therapeutics for substance use disorder in primary care (DIGITS Trial). Implement Sci. 2023 Feb 1;18(1):3. doi: 10.1186/s13012-022-01258-9. PMCID: PMC9893639.
PMID: 36726127
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2022

Blanchard BE, Mata-Greve F, Johnson M, Fortney JC. Knowledge about Treatment (KaT) in Mental Health Services. Meas Eval Couns Dev. 2023;56(2):81-98. doi: 10.1080/07481756.2022.2041439. Epub 2022 Apr 11. PMCID: PMC10292725.
PMID: 37378000
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Hoeft TJ, Hall JD, Solberg LI, Takamine LH, Danna MN, Fortney JC, Shushan S, Cohen DJ. Clinician Experiences With Telepsychiatry Collaborative Care for Posttraumatic Stress Disorder and Bipolar Disorder. Psychiatr Serv. 2022 Nov 29:appips202100595. doi: 10.1176/appi.ps.202100595. Epub ahead of print.
PMID: 36444528
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Hawkins EJ, Lott AM, Danner AN, Malte CA, Dulin PL, Fortney JC, Sayre GG, Baer JS. U.S. veterans' experiences and factors associated with use of a smartphone application to self-manage unhealthy alcohol use. Psychol Serv. 2022 Oct 13. doi: 10.1037/ser0000716. Epub ahead of print.
PMID: 36227298
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Wong, E. S., Rajan, S., Liu, C.-F., Morland, L. A., Pyne, J. M., Simsek-Duran, F., Reisinger, H. S., Moeckli, J., & Fortney, J. C. (2022). Economic costs of implementing evidence-based telemedicine outreach for posttraumatic stress disorder in VA. Implementation Research and Practice, 3. https://doi.org/10.1177/26334895221116771
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Barnard LM, Johnson RL, Brandspigel S, Rooney LA, McCarthy M, Meador L, Rivara FP, Rowhani-Rahbar A, Knoepke CE, Fortney JC, Peterson RA, Betz ME. Voluntary, temporary out-of-home firearm storage: A survey of firearm retailers and ranges in two states. Prev Med. 2022 Aug 26:107220. doi: 10.1016/j.ypmed.2022.107220. Epub ahead of print.
PMID: 36037869
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Cerimele JM, Johnson M, Blanchard BE, Russo J, Unützer J, Fortney JC. Bipolar disorder in primary care: Medication treatment by co-located psychiatrists versus primary care clinicians supported by psychiatrists. Gen Hosp Psychiatry. 2022 Aug 4;78:108-110. doi: 10.1016/j.genhosppsych.2022.08.001. Epub ahead of print.
PMID: 35985201
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Sterling RA, Liu CF, Hebert PL, Fortney JC, Swankoski KE, Katon JG, Wong ES. How did Veterans' Reliance on Veterans Health Administration Outpatient Care Change After Expansion of the Veterans Community Care Program? Med Care. 2022 Aug 11. doi: 10.1097/MLR.0000000000001764. Epub ahead of print.
PMID: 35950930.
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Munson SA, Friedman EC, Osterhage K, Allred R, Pullmann MD, Areán PA, Lyon AR; UW ALACRITY Center Researchers. Usability Issues in Evidence-Based Psychosocial Interventions and Implementation Strategies: Cross-project Analysis. J Med Internet Res. 2022 Jun 14;24(6):e37585. doi: 10.2196/37585.
PMID: 35700016
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Hall JD, Danna MN, Hoeft TJ, Solberg LI, Takamine LH, Fortney JC, Nolan JP, Cohen DJ. Patient and Clinician Perspectives on Two Telemedicine Approaches for Treating Patients with Mental Health Disorders in Underserved Areas. J Am Board Fam Med. 2022 May-Jun;35(3):465-474. doi: 10.3122/jabfm.2022.03.210377.
PMID: 35641048
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Austin EJ, Briggs ES, Ferro L, Barry P, Heald A, Curran GM, Saxon AJ, Fortney J, Ratzliff AD, Williams EC. Integrating Routine Screening for Opioid Use Disorder into Primary Care Settings: Experiences from a National Cohort of Clinics. J Gen Intern Med. 2022 May 25:1–9. doi: 10.1007/s11606-022-07675-2. Epub ahead of print. PMCID: PMC9132563.
PMID: 35614169
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Fortney JC, Rajan S, Reisinger HS, Moeckli J, Nolan JP, Wong ES, Rise P, Petrova VV, Sayre GG, Pyne JM, Grubaugh A, Simsek-Duran F, Grubbs KM, Morland LA, Felker B, Schnurr PP. Deploying a telemedicine collaborative care intervention for posttraumatic stress disorder in the U.S. Department of Veterans Affairs: A stepped wedge evaluation of an adaptive implementation strategy. Gen Hosp Psychiatry. 2022 Mar 26;77:109-117. doi: 10.1016/j.genhosppsych.2022.03.009. Epub ahead of print.
PMID: 35596963.
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Fortney JC, Carey EP, Rajan S, Rise PJ, Gunzburger EC, Felker BL. A Comparison of Patient-Reported Mental Health Outcomes for the Department of Veterans Affairs' Regional Telehealth and Community Care Programs. Health Serv Res. 2022 Apr 25. doi: 10.1111/1475-6773.13993. Epub ahead of print.
PMID: 35467011.
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Severe J, Pfeiffer PN, Palm-Cruz K, Hoeft T, Sripada R, Hawrilenko M, Chen S, Fortney J. Clinical Predictors of Engagement in Teleintegrated Care and Telereferral Care for Complex Psychiatric Disorders in Primary Care: a Randomized Trial. J Gen Intern Med. 2022 Feb 2. doi: 10.1007/s11606-021-07343-x. Epub ahead of print.
PMID: 35106719
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LaRocco-Cockburn A, Jakupcak M, Bauer AM, Bowen DJ, Bechtel J, Koconis N, Fortney JC. Care managers' experiences in a collaborative care program for the treatment of bipolar disorder and PTSD in underserved communities. Gen Hosp Psychiatry. 2022 Mar 7;76:16-24. doi: 10.1016/j.genhosppsych.2022.03.004. Epub ahead of print.
PMID: 35313202
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Locke ER, Young JP, Battaglia C, Simpson TL, Trivedi R, Simons C, Fortney JC, Hebert P, Swenson ER, Edelman J, Fan VS. Care-seeking and delay of care during COPD exacerbations. NPJ Prim Care Respir Med. 2022 Feb 15;32(1):7. doi: 10.1038/s41533-022-00269-9.
PMID: 35169140

Grubbs KM, Abraham TH, Pyne JM, Greene CJ, Teng EJ, Fortney JC. Enhancing Problem-Solving Therapy With Smartphone Technology: A Pilot Randomized Controlled Trial. Psychiatr Serv. 2022 Feb 10:appips201900254. doi: 10.1176/appi.ps.201900254. Epub ahead of print.
PMID: 35139654
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Van Tiem J, Wirtz E, Suiter N, Heeren A, Fuhrmeister L, Fortney J, Reisinger H, Turvey C. The Implementation of Measurement-Based Care in the Context of Telemedicine: Qualitative Study. JMIR Ment Health. 2022 Nov 24;9(11):e41601. doi: 10.2196/41601. PMCID: PMC9732750.
PMID: 36422884
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2021

 

Buck B, Gagen EC, Halverson TF, Nagendra A, Ludwig KA, Fortney JC. A systematic search and critical review of studies evaluating psychometric properties of patient-reported outcome measures for schizophrenia. J Psychiatr Res. 2021 Dec 27;147:13-23. doi: 10.1016/j.jpsychires.2021.12.053. Epub ahead of print.
PMID: 35007807

Blanchard BE, Johnson M, Hawrilenko M, Bechtel JM, Shushan S, Fortney JC. Psychometric properties of the Telepsych User Experience Scale (TUES). J Rural Health. 2021 Dec 27. doi: 10.1111/jrh.12640. Epub ahead of print.
PMID: 34957607

Littman AJ, Bratman GN, Lehavot K, Engel CC, Fortney JC, Peterson A, Jones A, Klassen C, Brandon J, Frumkin H. Nature versus urban hiking for Veterans with post-traumatic stress disorder: a pilot randomised trial conducted in the Pacific Northwest USA. BMJ Open. 2021 Sep 23;11(9):e051885. doi: 10.1136/bmjopen-2021-051885.
PMID: 34556516

Commiskey P, Armstrong AW, Coker TR, Dorsey ER, Fortney JC, Gaines KJ, Gibbons BM, Nguyen HQ, Singla DR, Szigethy E, Krupinski EA. A Blueprint for the Conduct of Large, Multisite Trials in Telemedicine. J Med Internet Res. 2021 Sep 20;23(9):e29511. doi: 10.2196/29511.
PMID: 34542417.

Fortney JC, Bauer AM, Cerimele JM, Pyne JM, Pfeiffer P, Heagerty PJ, Hawrilenko M, Zielinski MJ, Kaysen D, Bowen DJ, Moore DL, Ferro L, Metzger K, Shushan S, Hafer E, Nolan JP, Dalack GW, Unützer J. Comparison of Teleintegrated Care and Telereferral Care for Treating Complex Psychiatric Disorders in Primary Care: A Pragmatic Randomized Comparative Effectiveness Trial. JAMA Psychiatry. 2021 Aug 25. doi: 10.1001/jamapsychiatry.2021.2318. Epub ahead of print.
PMID: 34431972.

Newman MW, Hawrilenko M, Jakupcak M, Chen S, Fortney JC. Access and attitudinal barriers to engagement in integrated primary care mental health treatment for rural populations. J Rural Health. 2021 Aug 24. doi: 10.1111/jrh.12616. Epub ahead of print.
PMID: 34427352.

Chen JA, Jakupcak M, McCann R, Fickel JJ, Simons CE, Campbell DG, Stryczek KC, Hoerster KD, Chaney EF, Oishi SM, Miner MN, Bonner LM, Fortney JC, Felker BL. Posttraumatic stress disorder collaborative care: A quality improvement study in veterans affairs primary care. Fam Syst Health. 2021 Jun;39(2):198-211. doi: 10.1037/fsh0000623.
PMID: 34410768.

Cerimele JM, Blanchard BE, Bechtel JM, Fortney JC. Clinician preferences for using bipolar disorder symptom severity and quality of life scales for measurement-based care. Gen Hosp Psychiatry. 2021 Aug 9:S0163-8343(21)00112-2. doi: 10.1016/j.genhosppsych.2021.08.003. Epub ahead of print.
PMID: 34392976

Bhat A, Nanda A, Murphy L, Ball AL, Fortney J, Katon J. A systematic review of screening for perinatal depression and anxiety in community-based settings. Arch Womens Ment Health. 2021 Jul 11. doi: 10.1007/s00737-021-01151-2. Epub ahead of print. PMID: .
PMID: 34247269

Suresh M, Young J, Fan V, Simons C, Battaglia C, Simpson TL, Fortney JC, Locke ER, Trivedi R. Caregiver Experiences and Roles in Care Seeking During COPD Exacerbations: A Qualitative Study. Ann Behav Med. 2021 Jun 24:kaab045. doi: 10.1093/abm/kaab045. Epub ahead of print.
PMID: 34165138

Lin LA, Fortney JC, Bohnert ASB, Coughlin LN, Zhang L, Piette JD. Comparing telemedicine to in-person buprenorphine treatment in U.S. veterans with opioid use disorder. J Subst Abuse Treat. 2021 May 28:108492. doi: 10.1016/j.jsat.2021.108492. Epub ahead of print.
PMID: 34175175.

Cerimele JM, Russo J, Bauer AM, Hawrilenko M, Pyne JM, Dalack GW, Kroenke K, Unützer J, Fortney JC. The Patient Mania Questionnaire (PMQ-9): a Brief Scale for Assessing and Monitoring Manic Symptoms. J Gen Intern Med. 2021 Jun 18. doi: 10.1007/s11606-021-06947-7. Epub ahead of print.
PMID: 34145517.

Carlo AD, Chan G, Arao RF, Vredevoogd MA, Fortney JC, Powers DM, Russo JE, Unützer J. Assessing the Impact of Different Depression Treatment Success Metrics on Organizational Performance. Psychiatr Serv. 2021 Apr 15:appips202000364. doi: 10.1176/appi.ps.202000364. Epub ahead of print.
PMID: 33853382.

Malte CA, Dulin PL, Baer JS, Fortney JC, Danner AN, Lott AMK, Hawkins EJ. Usability and Acceptability of a Mobile App for the Self-Management of Alcohol Misuse Among Veterans (Step Away): Pilot Cohort Study. JMIR Mhealth Uhealth. 2021 Apr 8;9(4):e25927. doi: 10.2196/25927.
PMID: 33830064.

Fischer EP, Curran GM, Fortney JC, McSweeney JC, Williams DK, Williams JS. Impact of Attitudes and Rurality on Veterans' Use of Veterans Health Administration Mental Health Services. Psychiatr Serv. 2021 Mar 11:appips201900275. doi: 10.1176/appi.ps.201900275. Epub ahead of print.
PMID: 33691490.

Chen JA, Matson TE, Lehavot K, Raue PJ, Young JP, Silvestrini MC, Fortney JC, Williams EC. Provider Perspectives on Implementing Shared Decision Making for PTSD Treatment in VA Primary Care. Adm Policy Ment Health. 2021 Feb 24. doi: 10.1007/s10488-021-01119-5. Epub ahead of print.
PMID: 33625623.

Fortney JC, Pyne JM, Hawrilenko M, Bechtel JM, Moore D, Nolan JP, Pfeiffer P, Shushan S, Shore JH, Bowen D. Psychometric Properties of the Assessment of Perceived Access to Care (APAC) Instrument. J Ambul Care Manage. 2021 Jan/Mar;44(1):31-45. doi: 10.1097/JAC.0000000000000358.
PMID: 33165120.

2020

 

Bechtel JM, Lepoire E, Bauer AM, Bowen DJ, Fortney JC. Care manager perspectives on integrating an mHealth app system into clinical workflows: A mixed methods study. Gen Hosp Psychiatry. 2021 Jan-Feb;68:38-45. doi: 10.1016/j.genhosppsych.2020.10.004. Epub 2020 Oct 17.
PMID: 33310012.

Pyne JM, Kelly PA, Fischer EP, Miller CJ, Connolly SL, Wright P, Zamora K, Koenig CJ, Seal KH, Fortney JC. Initial concurrent and convergent validity of the Perceived Access Inventory (PAI) for mental health services. Psychol Serv. 2020 Oct 8. doi: 10.1037/ser0000504. Epub ahead of print.
PMID: 33030947.

Howland M, Tennant M, Bowen DJ, Bauer AM, Fortney JC, Pyne JM, Shore J, Cerimele JM. Psychiatrist and Psychologist Experiences with Telehealth and Remote Collaborative Care in Primary Care: A Qualitative Study. J Rural Health. 2020 Oct 6. doi: 10.1111/jrh.12523. Epub ahead of print.
PMID: 33022079.

Unützer J, Carlo AC, Arao R, Vredevoogd M, Fortney J, Powers D, Russo J. Variation In The Effectiveness Of Collaborative Care For Depression: Does It Matter Where You Get Your Care? Health Aff (Millwood). 2020 Nov;39(11):1943-1950. doi: 10.1377/hlthaff.2019.01714.
PMID: 33136506.

Bauer AM, Jakupcak M, Hawrilenko M, Bechtel J, Arao R, Fortney JC. Outcomes of a health informatics technology-supported behavioral activation training for care managers in a collaborative care program. Fam Syst Health. 2020 Aug 27. doi: 10.1037/fsh0000523. Epub ahead of print.
PMID: 32853001.

Katon JG, Callegari LS, Bossick AS, Fortney J, Gerber MR, Lehavot K, Lynch KE, Ma E, Smith R, Tartaglione E, Gray KE. Association of Depression and Post-Traumatic Stress Disorder with Receipt of Minimally Invasive Hysterectomy for Uterine Fibroids: Findings from the U.S. Department of Veterans Affairs. Womens Health Issues. 2020 Sep-Oct;30(5):359-365. doi: 10.1016/j.whi.2020.06.005. Epub 2020 Jul 22.
PMID: 32712008.

Goldberg SB, Fortney JC, Chen JA, Young BA, Lehavot K, Simpson TL. Military Service and Military Health Care Coverage are Associated with Reduced Racial Disparities in Time to Mental Health Treatment Initiation. Adm Policy Ment Health. 2020 Jul;47(4):555-568. doi: 10.1007/s10488-020-01017-2. PMCID: PMC7357226.
PMID: 31989399.

Campbell SB, Erbes C, Grubbs K, Fortney J. Social Support Moderates the Association Between Posttraumatic Stress Disorder Treatment Duration and Treatment Outcomes in Telemedicine-Based Treatment Among Rural Veterans. J Trauma Stress. 2020 Aug;33(4):391-400. doi: 10.1002/jts.22542. Epub 2020 Jun 10.
PMID: 32521100.

Cerimele JM, LePoire E, Fortney JC, Hawrilenko M, Unützer J, Bauer AM. Bipolar disorder and PTSD screening and telepsychiatry diagnoses in primary care. Gen Hosp Psychiatry. 2020 Jul-Aug;65:28-32. doi: 10.1016/j.genhosppsych.2020.05.006. Epub 2020 May 19.
PMID: 32447194.

Campbell SB, Gray KE, Hoerster KD, Fortney JC, Simpson TL. Differences in functional and structural social support among female and male veterans and civilians. Soc Psychiatry Psychiatr Epidemiol. 2020 Apr 6;. Doi: 10.1007/s00127-020-01862-4. [Epub ahead of print] PubMed
PMID: 32249329.

2019

 

Katon JG, Bossick AS, Doll KM, Fortney J, Gray KE, Hebert P, Lynch KE, Ma EW, Washington DL, Zephyrin L, Callegari LS. Contributors to Racial Disparities in Minimally Invasive Hysterectomy in the US Department of Veterans Affairs. Med Care. 2019 Dec;57(12):930-936. doi: 10.1097/MLR.0000000000001200.
PMID: 31730567.

Fortney JC, Heagerty PJ, Bauer AM, Cerimele JM, Kaysen D, Pfeiffer PN, Zielinski MJ, Pyne JM, Bowen D, Russo J, Ferro L, Moore D, Nolan JP, Fee FC, Heral T, Freyholtz-London J, McDonald B, Mullins J, Hafer E, Solberg L, Unützer J. Study to promote innovation in rural integrated telepsychiatry (SPIRIT): Rationale and design of a randomized comparative effectiveness trial of managing complex psychiatric disorders in rural primary care clinics. Contemp Clin Trials. 2020 Mar;90:105873. doi: 10.1016/j.cct.2019.105873. Epub 2019 Oct 31.
PMID: 31678410.

Browne KC, Chen JA, Hundt NE, Hudson TJ, Grubbs KM, Fortney JC. Veterans self-reported reasons for non-attendance in psychotherapy for posttraumatic stress disorder. Psychol Serv. 2019 Jul 22:10.1037/ser0000375. doi: 10.1037/ser0000375. Online ahead of print. PMC7147996
PMID: 31328929.

Browne KC, Hoerster KD, Piegari R, Fortney JC, Nelson KN, Post EP, Fihn SD, Mori AM, Trivedi RB. Clinical Care Quality Among Veterans Health Administration Patients With Mental Illness Following Medical Home Implementation. Psychiatr Serv. 2019 Sep 1;70(9):816-823. doi: 10.1176/appi.ps.201800474. Epub 2019 Jul 16.
PMID: 31310189.

Pyne JM, Kelly PA, Fischer EP, Miller CJ, Wright P, Zamora K, Koenig CJ, Stanley R, Seal K, Fortney JC. Development of a Perceived Access Inventory for Community Care Mental Healthcare Services for Veterans. Mil Med. 2019 Jul 1;184(7-8):e301-e308. doi: 10.1093/milmed/usy429. PMC7521611
PMID: 30690462.

Campbell SB, Fortney J, Simpson TL, Jakupcak M, Wagner A. Change in social support while participating in behavioral activation for PTSD. Psychol Trauma. 2019 Nov;11(8):905-908. doi: 10.1037/tra0000470. Epub 2019 May 20.
PMID: 31107046.

Owen RR, Woodward EN, Drummond KL, Deen TL, Oliver KA, Petersen NJ, Meit SS, Fortney JC, Kirchner JE. Using implementation facilitation to implement primary care mental health integration via clinical video telehealth in rural clinics: protocol for a hybrid type 2 cluster randomized stepped-wedge design. Implement Sci. 2019 Mar 21;14(1):33. doi: 10.1186/s13012-019-0875-5. PMC6429823
PMID: 30898129.

Goldberg SB, Simpson TL, Lehavot K, Katon JG, Chen JA, Glass JE, Schnurr PP, Sayer NA, Fortney JC. Mental Health Treatment Delay: A Comparison Among Civilians and Veterans of Different Service Eras. Psychiatr Serv. 2019 May 1;70(5):358-366. doi: 10.1176/appi.ps.201800444. Epub 2019 Mar 7. PMC6510540
PMID: 30841842.

Wong ES, Maciejewski ML, Hebert PL, Fortney JC, Liu CF. Spillover Effects of Massachusetts Health Reform on Mental Health Use by VA and Medicare Dual Enrollees. Adm Policy Ment Health. 2019 Mar;46(2):145-153. doi: 10.1007/s10488-018-0900-z.
PMID: 30343347.

Spottswood M, Fortney J, Chen JA, Davydow D, Huang H. Posttraumatic Stress Disorder in the Primary Care Setting: Summary of Recommended Care. Harv Rev Psychiatry. 2019 Mar/Apr;27(2):87-93. doi: 10.1097/HRP.0000000000000201.
PMID: 30614927.

Chen JA, Fortney JC, Bergman HE, Browne KC, Grubbs KM, Hudson TJ, Raue PJ. Therapeutic alliance across trauma-focused and non-trauma-focused psychotherapies among veterans with PTSD. Psychol Serv. 2020 Nov;17(4):452-460. doi: 10.1037/ser0000329. Epub 2019 Feb 11. PMCID: PMC6689461.
PMID: 30742471.

Cerimele JM, Goldberg SB, Miller CJ, Gabrielson SW, Fortney JC. Systematic Review of Symptom Assessment Measures for Use in Measurement-Based Care of Bipolar Disorders. Psychiatr Serv. 2019 May 1;70(5):396-408. doi: 10.1176/appi.ps.201800383. Epub 2019 Feb 5. PMC6543835
PMID: 30717645.

Bensley KM, Fortney J, Chan G, Dombrowski JC, Ornelas I, Rubinsky AD, Lapham GT, Glass JE, Williams EC. Differences in Receipt of Alcohol-Related Care Across Rurality Among VA Patients Living With HIV With Unhealthy Alcohol Use. J Rural Health. 2019 Jun;35(3):341-353. doi: 10.1111/jrh.12345. Epub 2019 Jan 31. PMC6639081
PMID: 30703856.

Cerimele JM, Fortney JC, Pyne JM, Curran GM. Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment. Fam Pract. 2019 Jan 25;36(1):32-37. doi: 10.1093/fampra/cmy019. PMC6346633
PMID: 29659789.

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Media (Webinars, podcasts, etc)

 

Veteran Reported Outcomes for Referrals to Community Care Providers Compared to Referrals to Regional Tele-Mental Health Hubs

Wednesday, March 17, 2021

Watch:

Veterans with poor access to mental health services at VA Medical Centers are eligible for Community Care or regional Telemental Health Hubs. This project compared patient reported outcomes for veterans referred to Community Care and Telemental Health Hubs.
Intended Audience: Researchers, clinicians, staff, and policy makers interested in make or buy decisions, and evaluating referral options for veterans in underserved CBOCs.