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Am Psychol ; 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393143


The integration of behavioral health in primary care is critical for addressing worldwide concerns for access to, and quality of, health care services for physical and mental health promotion, prevention, and disease management. Clearly, promoting knowledge exchange internationally is critical to progress. In late 2015, the American Psychological Association convened an interdisciplinary summit on global approaches to integrated health care, bringing together 82 health care professionals (nurses, primary care physicians, psychologists, psychiatrists, and social workers) and scholars from diverse disciplines in medicine, psychology, economics, health policy, public health, and demography; participants came from 10 countries. The Global Summit provided an opportunity to share best practices and innovation in patient-centered integrated health care internationally. In this article, Global Summit participants from different countries reflect on the recommendations for future interprofessional endeavors across the following themes: build international interprofessional communities for change; advocate for, and promote social equity with, a population health and patient focus; advance research and program evaluation in integrated care; advance interprofessional training and education in integrated care; and develop financially sustainable models for integrated primary care. Building upon these recommendations and reflecting on current advancement in health care policy and integrated care research, new directions are suggested for clinicians, researchers, administrators, and policymakers working toward the advancement of integrated care to improve health care services globally. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

MMWR Morb Mortal Wkly Rep ; 66(29): 769-772, 2017 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-28749927


Research suggests that many disparities in overall health and well-being are rooted in early childhood (1,2). Stressors in early childhood can disrupt neurologic, metabolic, and immunologic systems, leading to poorer developmental outcomes (1). However, consistent, responsive caregiving relationships and supportive community and health care environments promote an optimal trajectory (3,4). The first 8 years of a child's life build a foundation for future health and life success (5-7). Thus, the cumulative and lifelong impact of early experiences, both positive and negative, on a child's development can be profound. Although the health, social service, and education systems that serve young children and their families and communities provide opportunities to support responsive relationships and environments, efforts by these systems are often fragmented because of restrictions that limit the age groups they can serve and types of services they can provide. Integrating relationship-based prevention and intervention services for children early in life, when the brain is developing most rapidly, can optimize developmental trajectories (4,7). By promoting collaboration and data-driven intervention activities, public health can play a critical role in both the identification of at-risk children and the integration of systems that can support healthy development. These efforts can address disparities by reducing barriers that might prevent children from reaching their full potential.

Serviços de Saúde da Criança/organização & administração , Disparidades nos Níveis de Saúde , Criança , Pré-Escolar , Humanos , Estados Unidos
Am J Prev Med ; 51(4 Suppl 2): S106-18, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27498167


Family-focused prevention programs have been shown to effectively reduce a range of negative behavioral health outcomes but have had limited reach. Three key barriers must be overcome to expand the reach of family-focused prevention programs and thereby achieve a significant public health impact. These barriers are (1) current social norms and perceptions of parenting programs; (2) concerns about the expertise and legitimacy of sponsoring organizations to offer parenting advice; and (3) a paucity of stable, sustainable funding mechanisms. Primary healthcare settings are well positioned to overcome these barriers. Recent changes within health care make primary care settings an increasingly favorable home for family-focused prevention and suggest possibilities for sustainable funding of family-focused prevention programs. This paper discusses the existing advantages of primary care settings and lays out a plan to move toward realizing the potential public health impact of family-focused prevention through widespread implementation in primary healthcare settings.

Terapia Familiar/métodos , Conhecimentos, Atitudes e Prática em Saúde , Serviços Preventivos de Saúde/economia , Atenção Primária à Saúde/tendências , Humanos , Poder Familiar , Patient Protection and Affordable Care Act , Normas Sociais , Estados Unidos
J Adolesc Health ; 35(6): 529.e1-6, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15581537


PURPOSE: To explore whether differences exist between chronically ill and healthy adolescents with regard to their attitudes about end-of-life (EOL) issues. METHODS: A convenience sample of 25 adolescents without and 25 with a chronic illness, aged 13 to 21 years, were surveyed in hospital clinics, using a 25-item instrument; 60% were female and 76% were African-American. Items were developed based on previous research, interviews with health care providers, and a focus group with patients. Data were analyzed using the Fisher's exact test for 2-tailed p values. RESULTS: Ninety-six percent of chronically ill and 88% of healthy teens want to share decision-making if they are very ill; 76% prefer to discuss their wishes earlier in the course of a life-threatening illness. There was a trend for chronically ill adolescents to prefer to wait until later in the course of their illness (32% at diagnosis, 32% when first ill, 20% first hospitalization, or 16% if dying), when compared with their healthy peers (68% at diagnosis, 20% first ill, 4% first hospitalization, 8% if dying) (p = .074). Chronically ill adolescents were significantly more likely to prefer to wait to have these discussions, if the data were collapsed for time (first hospitalized and/or dying) (Fisher's p = .037). Half of all adolescents believed that they would be allowed to change their minds once they had made a decision. Eighty percent of chronically ill and 68% of healthy teens believed that their doctor would respect their wishes, while many were uncertain. CONCLUSIONS: Even teenagers without chronic illness have thoughts about end-of-life issues and have opinions remarkably similar to those of chronically ill teens. Those who are chronically ill are less likely to wish to discuss EOL issues early in their illness.

Comportamento do Adolescente , Diretivas Antecipadas , Atitude Frente a Morte , Doença Crônica , Tomada de Decisões , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Diretivas Antecipadas/psicologia , Diretivas Antecipadas/estatística & dados numéricos , Atitude Frente a Saúde , Doença Crônica/psicologia , Medo , Feminino , Grupos Focais , Humanos , Masculino , Psicologia do Adolescente , Fatores de Risco , Inquéritos e Questionários , Estados Unidos