Karina W. Davidson
Columbia University Medical Center
Treating a Depressed Cardiac patient: From Research to Practice and Back
Previous studies have shown that behavioral and psychosocial factors are associated with increased risk of adverse cardiac events among patients with coronary heart disease. As a result, there have been a number of efforts to develop, implement, and evaluate the impact of psychosocial and behavioral interventions on these risk factors as well as on important medical outcomes. In this case presentation the effects of treating two widely recognized risk factors–depression and low adherence to medications—will be discussed from a research and practice perspective. Millions of patients worldwide who had a recent heart attack are either depressed, have poor adherence to their medical regimen, or have both risk factors. The findings from recent randomized controlled trials will be discussed, along with the future role of system, behavioral, and psychosocial interventions in the rehabilitation and treatment of patients with coronary heart disease.
Karina Davidson, PhD is Professor of Behavioral Medicine in Medicine, Cardiology, and Psychiatry at Columbia College of Physicians and Surgeons, and also as the Director of the Center for Behavioral & Cardiovascular Health. She is a clinical health psychologist by training. Her program of research focuses on the relationship between psychosocial risk factors and their role in the course and outcome of cardiovascular disease. She has conducted randomized controlled trials of anger management and depression treatment for both hypertensive and post-myocardial infarction patients. Most recently Dr. Davidson conducted an NIH-funded randomized controlled trial to test if enhanced depression treatment vs current treatment improves healthcare costs and depression in acute coronary disease patients at sites across the U.S. Dr. Davidson was recently awarded a New York State Department of Health program project to investigate novel hospital system interventions for improving 30-day readmissions for patients presenting with heart failure, chronic obstructive pulmonary disease, or myocardial infarction. She is working closely with leadership from New York Presbyterian hospital system to improve patient flow through the emergency department to medicine units at multiple hospitals. This past year, she was also awarded a PCORI grant to investigate which conditions and symptoms in primary care patients should be targeted for treatment in N-of-1 trials.
A Proposal to Build Capacity to Disseminate Health Psychology Services in Australia
This paper will describe work completed in 2016 by a committee working under the auspice of the Australian Psychological Society (APS) College of Health Psychologists to plan a new service that will source and then sell health psychology services within Australia. The plan that has been drafted outlines how a range of services could be offered on a commercial basis including: public education seminars; and health promotion interventions that have strong empirical evidence supporting their effectiveness and cost-effectiveness of the interventions; and training accreditation in evidence-based health psychology interventions. The presentation will describe the rationale for disseminating health psychology interventions and the practical challenges that need to be considered.
Professor Toumbourou is the Chair in Health Psychology within the School of Psychology at Deakin University. He is the Leader of Intervention Sciences in the Deakin University Centre for Social and Early Emotional Development (www.deakin.edu.au/psychology/psychology-research/seed). He is a prominent social advocate in areas related to child and adolescent mental health promotion and the prevention of alcohol and drug problems. Professor Toumbourou has been influential internationally and nationally in assisting the development of research and practice in the fields of prevention science and health psychology. He serves as the Chief Executive Officer of the not-for-profit company Communities That Care Ltd (www.communitiesthatcare.org.au), established under the auspice of the Royal Children’s Hospital to assist communities deliver evidence-based prevention programs.
Improving outcomes in chronic disease: What are we missing?
Chronic disease is the leading cause of illness, disability and death in Australia accounting for 90% of all deaths. The personal, social and economic impact of chronic disease is the biggest health challenge that Australia faces. By 2020 chronic disease or NCDs will account for 57% of the global disease burden. Quality research must ultimately lead to economic and social benefit on a local, regional and global scale. In order for this to occur in chronic disease we need 1) a well targeted and responsive research agenda, 2) community engagement, and 3) an openness to new ways of thinking. While in some specific areas, such as tobacco control, Australia has achieved notable public health success, these have come with a disadvantage cost for some individuals and groups. As well, when commercial and sectoral interests drive research interpretation a conflict between evidence and practice can arise. There is a need for a conversation in psychology about how values and context influences research translation into public policy and practices in health.
Professor Suzanne Chambers is a health psychologist and has worked as a practitioner and researcher in psychological support for people with cancer for over 25 years. She is the Director of the Menzies Health Institute Queensland at Griffith University. Suzanne has published extensively on the psychological effects of cancer and is currently leading an NHMRC Centre for Research Excellence in Prostate Cancer Survivorship. She has been a chief investigator on successful research grants valued at over $31.5 million including National Health and Medical Research Council, Australian Research Council, Prostate Cancer Foundation of Australia, Cancer Australia, Beyond Blue and Cancer Council Queensland. She has over 200 peer reviewed publications, chapters and reports. Her research is published in internationally leading journals including the Journal of Clinical Oncology, The Lancet and Lancet Oncology, and Psycho-Oncology.