Treatment of Adolescent Depression in Primary Care
Staff & Consultants
Co-Principal Investigator
Audrey Burnam (Ph.D., Social Psychology, University of Texas at Austin) directs RAND’s Center for Research on Alcohol, Drugs, and Mental Health. She has led studies on the epidemiology of mental health and substance abuse problems and on the organization, financing, and effectiveness of services for individuals with mental health needs. She participates in a national research collaboration focusing on mental health policy issues as a member of the MacArthur Network on Mental Health Policy Research. She also serves as a member of NCQA’s Measurement Advisory Panel, where she provides guidance on the development of behavioral health measures for inclusion in HEDIS. Her current research focuses on access to mental health and substance abuse treatment; the impact of financing and managed care on access to and quality of behavioral health care; and services delivery issues for special populations, including adolescents, adults with severe mental illness, those with HIV, and those with co-occurring substance abuse and mental disorders.
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Co-Principal Investigator
Lisa H. Jaycox (Ph.D. in Clinical Psychology, University of Pennsylvania) is a Behavioral Scientist who focuses on intervention for children and adolescents, including both depression and anxiety, particularly reactions to traumatic events. A theme that crosses her projects is the dissemination of effective treatments to community settings, including schools and primary care. She has developed psychosocial interventions for depression and symptoms of post-traumatic stress disorder, and is the RAND PI of an AHRQ-funded study based at UCLA that developed and is evaluating a quality improvement intervention for adolescents in primary care settings. Dr. Jaycox will act as Co-Principal Investigator on the Teen Depression Awareness Project (TDAP), and will focus on usual care practices, and the impact of FPA on care.
TDAP Staff
Daniela Golinelli (Ph.D., Statistics, University of Washington, 2000). Dr. Golinelli, after completing her dissertation in August 2000, took a visiting assistant professor position at the Department of Mathematics and Center for Computational and Experimental Genomics, University of Southern California. In August 2002, she joined RAND as an associate statistician. Dr Golinelli methodological research interests focus on the development of inferential methods for stochastic population models, in particular hidden Markov models or partially observed stochastic population processes, and Bayesian statistics. She has applied these methods in hematology to inform the development of new cancer treatments. Since joining RAND, she has been involved in several health policy research projects. In particular, she is collaborating with Drs Wenzel and Tucker on a project that determines the correlates of HIV risk behaviors and the impact of HIV risk behaviors on health outcomes among low-income housed and homeless women.
She is also the project statistician for a study, led by Dr Bird, that examines the relationships between gender, gender of sexual partners, use of HAART and other utilization, and sexual risk behavior in a sample of HIV positive individuals.
Lisa Meredith, PhD, is a Senior Behavioral Scientist at RAND and a Research Associate at the VA/UCLA/RAND Center of Excellence for the study of Health Care Provider Behavior. She conducts health services evaluation research to improve the quality of care for depression in primary care managed care settings. Her current work also includes a project funded by the National Institute of Mental Health (NIMH) applying health behavior models to understanding how primary care providers deliver quality care to patients with depression. Recently, she completed an NIMH study of counseling by primary care providers and a Robert Wood Johnson Foundation (RWJF) grant examining the strength of the patient-provider relationship under different managed care arrangements. She was Co-PI on an NIMH project that evaluated the effects of team-based quality improvement on care for depression, a member of the steering committee for Quality Improvement for Depression, a multi-study consortium studying guideline-concordant care for depression, and evaluated the impact of the Institute for Healthcare Improvement's Improving Chronic Illness Care Evaluation for depression funded by RWJF. As a Co-PI on a grant funded by the Agency for Health Research and Quality depression PORT-II, she led the primary care provider evaluation. On the Medical Outcomes Study, she led the work on clinician style of care and developed an evaluation framework for studying the attitudes and perceptions of clinicians in caring for and treating patients with psychosocial problems, depression, and anxiety. She is a recipient of the Distinguished Reviewer Award from the Society for General Internal Medicine and has published numerous peer-reviewed journal articles, authored a NIMH book chapter on counseling for depression, co-authored a book on depression in primary care, and is currently Deputy Editor of Medical Care.
Judy Perlman, Survey Director (M.A., Educational Psychology, California State University, Northridge) is the Deputy Directory of RAND's Survey Research Group. Ms. Perlman has 20 years of experience in planning and directing large-scale data collection projects in the health sciences. She has expertise in data collection design and methodology and has directed data collection for large and complex projects involving difficult populations, such as the homeless, prostitutes, physicians, and residents of disadvantaged communities. Ms. Perlman has worked closely with administrators of health service centers and health maintenance organizations to establish cooperation between the providers of information and the data collection staff. Ms. Perlman has extensive experience in training and has been consultant for several research institutions, universities and treatment centers for her expertise in data collection methodologies, training, and implementation strategies. She has worked with physicians to develop procedures, training and implementation for interviewer administered health exams of a homeless population in Los Angeles. She is trainer for the Diagnostic Interview Schedule, and has been trained in the CIDI by trainers from the University of Michigan and the World Health Organization. Her experience includes study design and study direction for the Epidemiological Catchment Area Project (Los Angeles), The Medical Outcomes Study, Course of Homelessness Study, Cost of AIDS Care Study, Indonesian Family Life Study and several Child Immunization studies involving household interviews and follow up interviews of African American mothers of
newborn babies. She recently coordinated site enrollment for a large scale HIV study (the HIV Costs and Services utilization Study HCSUS), directed data collection for a Homeless Women's Health Study, the NIMH funded study on Improving HIV Treatment for the Seriously Mentally Ill, and Suzanne Wenzel's study of Drug Abuse, Violence and HIV/AIDS Among Impoverished Women that was sponsored by NIDA. Currently underway are a NIDA study on Hepatitis B and C and HIV among the Homeless Adults, and the NIMH-funded Veteran's Administration Study on Outcomes to Homeless Veterans.
Mayde Rosen, R.N., B.S.N. is a Project Administrator in the health care division of RAND. She has worked extensively in the areas of data gathering and dissemination, and data cleaning and system editing for medical and fiscal accuracy. She has chaired and formed interdisciplinary work teams to improve clinical quality, decrease length of stay and ancillary testing, and improve cost effectiveness and utilization management. She has been the liaison with outside vendors for cost accounting and national benchmarking for data comparisons. She joined RAND in July 1998 and is the Project Administrator for a Robert Wood Johnson Foundation funded study entitled Improving Chronic Illness Care Evaluation (ICICE) and the coordinator of the RAND Clinical Scholars Program (CSP).
She is has also participated in the combined US Armed Services and Veteran’s Administration project to streamline the care of patients by implementing guidelines, and a Cost of Cancer Treatment Study which will help establish the cost of patients on chemotherapy trials in comparison with those who are not. Currently she is the Project Administrator for the following projects: ICICE, the National Initiative for Cancer Care Quality (NICCQ), the Cancer Care Outcomes Research and Surveillance (CanCORS), and Developing Standards for Electronic Prescribing Systems (E-Rx).
January 2004
Michael Seid received his BA from UCLA and his doctorate in Psychology from the University of Illinois, at Urbana-Champaign. After a clinical internship at UCSD, he worked at the Center for Child Health Outcomes at Children’s Hospital in San Diego, where he was Research Scientist and Associate Director for Research. Dr. Seid’s areas of expertise include measuring and improving pediatric health care quality and health-related quality of life, program evaluation, quasi-experimental methods and data analysis, the interface between managed care and child health, and research ethics. He is an expert in using real-time science to generate knowledge for operational and policy health care decision makers and in understanding the intersection between science and managed care in a pediatric health system. Dr. Seid served as the Chair of Children’s Hospital’s Institutional Review Board and as a member of the Health Care Quality and Effectiveness Research (HCQER) Study Section at the Agency for Healthcare Quality and Research. In addition to several national expert panels, he is on the Review Board of the Journal of Clinical Outcomes Management and an ad hoc reviewer for Pediatrics and the Journal of Ambulatory Pediatrics. He has published widely in such journals as Medical Care, HSR: Health Services Research, Archives of Pediatrics and Adolescent Medicine, Pediatrics, American Journal of Medical Quality, the Journal of Ambulatory Pediatrics, and Milbank Quarterly.
Bradley Stein, MD, PhD. Bradley Stein is Associate Director for Mental and Behavioral Health in the RAND Center for Domestic and International Health Security. He is a Natural Scientist at RAND and Assistant Professor of Child Psychiatry at the Keck School of Medicine, University of Southern California.
Dr. Stein’s major research interests combine child mental health services and efforts to improve the quality of mental health care in community settings. He is working collaboratively with the Los Angeles Unified School District’s Mental Health Services Unit, other school stakeholders, and colleagues at UCLA in the continuing development and evaluation of a school-based mental health program for students exposed to violence. Additional work includes an examination of violence exposure and trauma-related distress symptoms among children in Los Angeles County Foster Care, and an evaluation of the implementation of LAUSD’s Youth Suicide Prevention Program.
Dr. Stein is currently a consultant to the Director of Research at the National Memorial Institute for the Prevention of Terrorism on the “Health, Mental Health, and Policy: How Terrorism Affects Us” project, and was a reviewer for the Institute of Medicine’s recent report Preparing for the Psychological Consequences of Terrorism. He serves as a Psychiatric Expert with the Los Angeles Unified School District Mental Health Services Unit, is a member of the Schools Committee of the American Academy of Child and Adolescent Psychiatry, and directs the School Consultation Program for the USC Division of Child Psychiatry. Dr. Stein is a former Robert Wood Johnson Foundation Clinical Scholar and National Institute of Mental Health Faculty Scholar.
Terri L. Tanielian, M.A. (Psychology, American University) is a Social Research Analyst and serves as both the Deputy Director of the Center for Military Health Policy Research and an Associate Director for Mental and Behavioral Health within the Center for Domestic and International Health Security at the RAND Corporation. She conducts mental health services research and policy analyses in both the military and civilian sector. She is currently Co-Principal Investigator on a DoD funded project to evaluate the impact of independent reimbursement of licensed and certified mental health counselors on utilization, costs, and outcomes of care under the TRICARE program. Other current projects include a study of national and regional level trends in mental health care delivery, as well as study aimed at describing the impact of depression on adolescent and family function and evaluating the effect of family and patient activation in motivating treatment seeking in adolescents with depression. She also recently completed a project to examine the relationship of health care decision-making and perception of risk among individuals treated for anthrax exposure during the fall of 2001 and was the lead analyst on a project that outlined the issues related to understanding and preparing for psychological consequences of terrorism. This project sought to highlight the range of psychological issues associated with terrorism and to identify gaps and challenges in preparing and responding to the associated consequences. Additionally, she has participated in a number of projects examining the public response to terrorism, including a project funded by the Sloan Foundation on civilian preparedness for catastrophic terrorism. Her recent work includes the development and adaptation of innovative chronic care models for the treatment and management of alcohol problems in primary care settings. Her research interests include the design and evaluation of mental health care systems for children, adolescents, and individuals with severe mental disorders; as well as psychological impact of terrorism, individual and school preparedness, risk communication, as well as psychological consequences management planning.
Ms. Tanielian has 10 years of experience in developing and evaluating mental health policy and has directed research activities for the American Psychiatric Association as well as the American Academy of Child and Adolescent Psychiatry before joining RAND. While at the APA, she led several research efforts aimed at documenting the clinical and treatment characteristics of psychiatric patients, practice patterns of psychiatrists, as well as evaluating practice guideline compliance among psychiatrists treating depression. At the AACAP she focused on issues related to children with severe emotional disorders, including psychopharmacology and the use of new evidence-based treatment technologies. She has published numerous peer-reviewed articles, authored a book chapter on the role of evidence in mental health care in the United States, and serves as a Co-Editor for the Datapoints Column in Psychiatric Services.
Stephanie Taylor (Ph.D., Sociomedical Sciences, Columbia University) is an Associate Social Scientist at RAND. Her research agenda for the last ten years has focused on HIV and mental health. Her most recent research has examined how regional, neighborhood or service characteristics correlate with regional variations in individuals’ health or service utilization among persons with HIV or mental health needs. She also has conducted spatial analyses to examine how location of HIV testing sites is related to individuals’ testing behaviors. Her interests also include examining racial/ethnic disparities in health and service utilization, focusing on how the care setting in which individuals receive services or the community in which individuals live contribute to those disparities.
Consultants
Joan Asarnow (Ph.D., University of Waterloo) is a Clinical Psychologist and Professor of Psychiatry and Biobehavioral Sciences at UCLA, and is the Co-Director of the UCLA Child and Adolescent Mood
Disorders Program and Anxiety Disorders Program. She is a recognized expert in mood disorders in children and adolescents, the association between depression and post-traumatic stress disorders in childhood, suicidal behavior in youth, cognitive-behavior therapy, and childhood-onset schizophrenia. In collaboration with Dr. Jaycox, Dr. Asarnow leads the Youth Partner in Care Study, funded by AHRQ, which aims to improve quality of care for depressed adolescents in primary care settings. Dr. Asarnow will serve as a project consultant.
Dr. Thomas Croghan is Senior Natural Scientist at RAND and a Visiting Scientist in the Department of Sociology at Indiana University. He has directed many studies of the quality, cost, and cost-effectiveness of antidepressant treatment as part of his appointment in the intramural outcomes research program at Eli Lilly and since joining RAND in 2003. He has also been co-PI or an investigator on extramural research projects that assess the determinants and outcomes of quality antidepressant treatment, including factors related to the patient, treatment, system of care, and the context in which people make decisions about antidepressant treatment. Dr. Croghan was also the principal project officer for work done by the National Bureau of Economic Research that created Price Indexes for the treatment of depression and other conditions. Follow up studies to this work have been funded by the NIMH. Dr. Croghan was the founding project officer for Lilly’s Schizophrenia Care and Assessment Program, an observational study of 2400 patients with schizophrenia, and a long-term advisor to that study.
Kelly Kelleher (M.D., Ohio State University, M.P.H., Johns Hopkins University) is the director of the Office of Clinical Sciences at Children's Research Institute and Professor of Pediatrics, The Ohio State University. Dr. Kelleher has led several federal research grants focused primarily on health, mental health and alcohol services research for high-risk children and their families. His focus has been on the impact of managed care on children and adolescents with chronic psychiatric, medical or alcohol problems. In addition, he has completed work on the quality of primary care services for youth, on outcomes and quality research, and in outcomes management and health report cards. Dr. Kelleher will serve as a project consultant.
Mark A. Schuster (B.A., Yale University; M.D., M.P.P., Harvard University; Ph.D., Policy Analysis, RAND Graduate School) is Associate Professor of Pediatrics and Public Health at UCLA, Senior Natural Scientist at RAND, and Co-Director of the RAND Center for Maternal, Child, and Adolescent Health Research. He is the Founder and Director of the UCLA/RAND Center for Adolescent Health Promotion, a community-based participatory research center funded by the CDC. Dr. Schuster conducts research primarily on child, adolescent, and family issues. Currently, he is leading an NIMH-funded project to develop and evaluate a worksite-based parenting program for parents of adolescents to learn communication skills and foster healthy sexual development and sexual risk prevention. He is head of the L.A. site of the CDC-funded “Healthy Passages,” which is seeking to identify the etiologies of and influences on health and behavioral outcomes by studying 5,250 ten-year olds in three cities annually to age 20. He is also conducting an NICHD study examining the impact of parents’ HIV on their uninfected children. Dr. Schuster has been studying the effects of the terrorist attacks on stress and coping in a nationally representative sample of Americans. He is on the pediatric team of the Global Quality Assessment Tool study, and has developed a set of indicators for measuring the quality of care for public health services. He has also been studying the quality of follow-up care for low birthweight infants, delivery of health supervision for children, and pediatric dental care utilization.
As a new Associate Director of the UCLA Robert Wood Johnson Clinical Scholars Program, Dr. Schuster oversees pediatric fellows and is developing a new community-based participatory research curriculum. Dr. Schuster is co-author of Everything You Never Wanted Your Kids to Know About Sex (But Were Afraid They’d Ask): The Secrets to Surviving Your Child’s Sexual Development from Birth to the Teens (Crown; 2003) and co-editor of Child Rearing in America: Challenges Facing Parents of Young Children (Cambridge University Press; 2002). Dr. Schuster is the 2003 winner of the Nemours Child Health Services Research Award from AcademyHealth. He practices pediatrics at Mattel Children’s Hospital at UCLA.
Survey Staff
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Crystal Kollross; Field Representative
Ana Suarez; Field Representative
Kirsten Becker; Survey Coordinator
Rebecca Pierce; Survey Assistant