Ongoing Projects

Assessing Depression Screening and Treatment at a Federally Qualified Health Center with Integrated Behavioral Health Services 

PI: Jennifer Berko

Depression screening and treatment in the primary care setting is essential for early identification and intervention for depressive disorders. Previous research has consistently demonstrated low rates of depression screening and appropriate follow-up in primary care settings, but little is known about rates of depression screening in health systems that provide integrated primary care and behavioral health services. Further, there are additional gaps in our knowledge of screening and treatment rates in underserved populations. This cross-sectional study aims to examine depression screening rates and to characterize the nature of depression treatment at a Federally Qualified Health Center that utilizes a fully integrated primary-care-behavioral-health model.

Perceived Discrimination and Cannabis Use Disorder 

PI: Rebecca Klege

Although discrimination has been well-studied as a risk factor for substance use and disorders, including tobacco, alcohol, and illicit drugs broadly, research specific to cannabis and discrimination is limited in scope and generalizability. The goal of this cross-sectional study is to characterize the relationship between experiences of everyday discrimination, cannabis use, and cannabis use disorder in a diverse, nationally representative sample of adults. Additionally, we will explore social support as a potential moderator of this relationship. This study will leverage comprehensive health data from the NIH “All of Us” Research program.

Dental-Nutrition Counselling for Overweight and Obese Children: A Retrospective Study 

PI: Jennifer Berko Co- PI: Rebecca Klege

Nutritional counseling in the dental setting may be a useful tool for addressing childhood overweight and obesity given the common nutritional risk factors between poor oral health and excess weight. While most dentists do provide nutritional counseling during routine appointments, it remains unclear if this counseling has any impact on weight or nutrition behaviors. This retrospective study aims to assess the impact of a dentist-delivered nutritional counseling intervention on weight and nutrition-related oral health behaviors in children aged 6-11 years’ old who received the intervention at Henry J Austin Health Center.

Controlling Hypertension in a Federally Qualified Health Center beyond Self Measured Blood Pressure Values

Rebecca Klege (PI), Thomas Bateman & Caitlin McCarthy (Co-PIs)

Remote Patient Monitoring (RPM) allows clinicians to further manage and monitor patients in a non-office setting. While RPMs have been regularly studied and have gained ground in the last decade, the recent occurrences of the COVID -19 pandemic have increased the interest of health institutions in adopting RPM solutions. Using Self-Measured Blood Pressure (SMBP) devices in a remote patient monitoring program can be associated with improved treatment compliance. The study aims to assess the impact of pharmacist-led intervention in self-measured blood pressure (SMBP) hypertension control program using a randomized control study design.

Working Alliance Inventory (WAI) Assessment in a Federally Qualified Health Center: The Role of Feedback and Peer Recovery Specialist. 

Rebecca Klege (PI), Lee Ruszczyk and Ivy Pearlstein (Co-PIs)

The therapeutic relationship between patients and providers is a vital element for successful care outcomes and can affect the adherence to treatment plans. The Working Alliance Inventory (WAI) is a standard assessment tool that is widely accepted in health care to evaluate therapeutic relationships. This quasi-experimental study broadly aims to assess the patient-provider bond by adopting the WAI in a Medication Assisted Treatment (MAT) Program at Henry J Austin Health Center.

Completed Projects

Behavioral Health Integration in Primary Care Setting: Lesson learned from adopting the Cherokee Model in New Jersey Practices. 

Rebecca Klege (PI), Ann Nguyen (PI)

Evidence suggests that behavioral health integration (BHI) into primary care settings is essential for providing and expanding care to patients suffering from mental conditions, substance use disorders, and lifestyle changes related to chronic medical conditions. Through the Nicholson Foundation, which awarded grants to New Jersey health organizations from 2002-2021, eleven primary care centers were funded to implement the Cherokee Health Systems’ model of integrated care in New Jersey. While the Cherokee BHI model is one of the few integration models that has been applauded for its many strengths, implementing the model across various states and demography can yield varied results and experiences. The study aims to explore the effectiveness and challenges of implementing the Cherokee integrated care model in New Jersey (NJ) health centers.

An Examination of Primary Care Provider Referral Patterns: Assessing the Impact of The  Covid-19 Pandemic on Long term Patient Outcomes. 

Ronald Jean (PI)

Specialty referrals are important for patient diagnostics and treatment, delays in diagnosis are likely to be associated with worse outcomes and higher costs. Additionally, referrals may be generated by PCP’s attempting to reduce the risk of malpractice. This action is described as defensive medicine which involves medical practice by way of diagnosing or treatment that is specifically applied to reduce the risk of malpractice litigation, typically by the use of excessive testing or referrals. The study aims to determine the difference between referral rates among primary care physicians (PCP) at Federally Qualified Health Centers (FQHC) during and post Covid-19 pandemic.

Development and Implementation of Innovative Interventions that Effectively Address Health Disparities. (Bristol Myers Squibb)  

Kemi Alli (PI), Rebecca Klege  (Co- PI)

The chronic disease burden in Trenton is disproportionately high relative to county, state, and national levels, particularly for members of disadvantaged BIPOC communities. Each year HJAHC sees thousands of patients annually for a myriad of chronic conditions while many more residents battling chronic illness simply go untreated. Chief among these chronic diseases are Hypertension, Cancer, Obesity and Diabetes. This project aims to establish HJAHC as a clinical research hub in Trenton by tackling these pressing health disparities. The project also aims to implement a training curriculum designed to educate and engage HJAHC teams, including patients, clinical and administrative staff, in Patient-Centered Outcome Research.