Matthew Aalsma

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https://hdl.handle.net/1805/6681

Health Care Access and Utilization by Youth in Juvenile Justice

Youth involved in the juvenile justice system are known to have significant medical and mental health difficulties. Matt Aalsma is concerned about the large number of youth in the juvenile justice system who are minorities and are impoverished. Dr. Aalsma is researching ways to link these youth to the medical and mental health care they need for successful reentry into community life. To help youth get connected to needed services, a medical and mental health care screening program is being tested at the Indianapolis Juvenile Detention Center. This project is funded through a federal grant from the Maternal and Child Health Bureau.

Successful practices developed here in Indiana can have a positive impact on youth in juvenile justice systems across the country. Professor Aalsma’s research seeks to improve the lives of youth in the juvenile justice system as well as their chances for successful transition to community life.

Dr. Aalsma’s project exploring how to link youth in the juvenile justice system to needed medical and mental health care is another example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.

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Browsing Matthew Aalsma by Subject "adolescent"

Now showing 1 - 5 of 5
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    Do Adolescents Consider Mind-Body Skills Groups an Acceptable Treatment for Depression? Results from a Pilot Study
    (BMC, 2021) Cunningham, Lindsey D.; Salgado, Eduardo F.; Aalsma, Matthew C.; Garabrant, Jennifer M.; Staples, Julie K.; Gordon, James S.; Salyers, Michelle P.; Psychology, School of Science
    Background Mind-Body Skills Groups (MBSGs) have shown promise in reducing adolescent depression symptoms; however, little is known about adolescents’ perspectives on this treatment. The objective of this study was to understand the acceptability of a new treatment for depressed adolescents in primary care settings. Methods Adolescents participating in a 10-week MBSG treatment were interviewed to understand their perspectives on the acceptability and effectiveness of the treatment. Interviews were collected at post-intervention and at a 3-month follow-up visit. Results A total of 39 adolescents completed both the post-intervention and 3-month follow-up interview. At post-intervention and follow-up, 84% of adolescents stated the MBSGs helped them. When asked how the MBSGs helped them, 3 areas were identified: learning new MBSG activities and skills, social connection with others within the group, and outcomes related to the group. Many adolescents reported no concerns with the MBSGs (49% at post- intervention; 62% at follow-up). Those with concerns identified certain activities as not being useful, wanting the group to be longer, and the time of group (after school) being inconvenient. Most adolescents reported that their life had changed because of the group (72% at post-intervention; 61% at follow-up), and when asked how, common responses included feeling less isolated and more hopeful. Conclusions Adolescents found the MBSGs to be helpful and acceptable as a treatment option for depression in primary care. Given the strong emphasis on treatment preference autonomy and the social activities within the group, MBSGs appear well-suited for this age group.
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    Getting a Grip on My Depression: How Latina Adolescents Experience, Self-Manage, and Seek Treatment for Depressive Symptoms
    (Sage, 2019-10) McCord Stafford, Allison; Aalsma, Matthew; Bigatti, Silvia; Oruche, Ukamaka M.; Burke Draucker, Claire; Pediatrics, School of Medicine
    Latina (female) adolescents are more likely to experience depressive symptoms and less likely to receive mental health services than their non-Latina White peers. We aimed to develop a framework that explains how Latina adolescents experience, self-manage, and seek treatment for depressive symptoms. Latina young women (n = 25, M age = 16.8 years) who experienced depressive symptoms during adolescence were recruited from clinical and community settings and interviewed about experiences with depressive symptoms. The framework was developed using constructivist grounded theory methods. Participants experienced a psychosocial problem that we labeled being overburdened and becoming depressed. They responded to this problem through a five-phase psychosocial process that we labeled Getting a Grip on My Depression. Family members, peer groups, and mainstream authorities were influential in how participants experienced these phases. Future research should further develop this framework in diverse samples of Latino/a youth. Clinicians can use this framework in discussions with Latina adolescents about depressive symptoms.
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    Let them speak for themselves: Improving adolescent self-report rate on pre-visit screening
    (Elsevier, 2019) Grout, Randall W.; Cheng, Erika R.; Aalsma, Matthew C.; Downs, Stephen M.; Pediatrics, School of Medicine
    Background Adolescent pre-visit screening on patient-generated health data is a common and efficient practice to guide clinical decision making. However, proxy informants (e.g., parents or caregivers) often complete these forms, which may lead to incorrect information or lack of confidentiality. Our objective was to improve the adolescent self-report rate on pre-visit screening. Methods We conducted an interventional study using an interrupted time-series design to compare adolescent self-report rates (percent of adolescents ages 12-18 years completing their own pre-visit screening) over 16 months in general pediatric ambulatory clinics. We collected data using a computerized clinical decision support system with waiting room electronic tablet screening. Pre-intervention rates were low, and we created and implemented two electronic workflow alerts, one each to the patient/caregiver and clinical staff, reminding them that the adolescent should answer the questions independently. We included the first encounter from each adolescent and evaluated changes in adolescent self-reporting between pre- and post-intervention periods using interrupted time series analysis. Results Patients or caregivers completed 2,670 qualifying pre-visit screenings across 19 pre-intervention, 7 intervention, and 44 post-intervention weeks. Self-reporting by younger adolescents nearly doubled with a significant increase of 19.3 percentage points (CI 9.1-29.5) from the baseline 20.5%. Among older adolescents, the stable baseline rate of 53.6% increased by 9.2 absolute percentage points (CI -7.0-25.3). There were no significant pre- or post-intervention secular trends. Conclusions Two automated alerts directing clinic personnel and families to have adolescents self-report significantly and sustainably improved younger adolescent self-reporting on electronic patient-generated health data instruments.
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    Pilot Randomized Trial of a Family Management Efficacy Intervention for Caregivers of African American Adolescents with Disruptive Behaviors
    (Springer, 2018) Oruche, Ukamaka M.; Robb, Sheri L.; Burke Draucker, Claire; Aalsma, Matthew C.; Pescosolido, Bernice; Chacko, Anil; Ofner, Susan; Bakoyannis, Giorgos; Brown-Podgorski, Brittany; School of Nursing
    Background Caregivers of adolescents diagnosed with Oppositional Defiant Disorder and/or Conduct Disorder (ODD/CD) experience unique challenges when interacting with child service systems involved in their adolescents’ care. Absent from the literature are interventions to improve these interactions, which in the long term may improve adolescent behavioral health outcomes. Objective To examine feasibility/acceptability of Family Management Efficacy (FAME) intervention content, structure, delivery, and appropriateness of selected measures for caregivers of African American adolescents with ODD/CD. Secondary aim was to explore changes in FAME caregivers’ interaction self-efficacy, stress, quality of life, and family functioning scores relative to caregivers receiving treatment as usual (TAU). Method A pilot two-group randomized trial was conducted with caregivers of African American adolescents (ages 12–18 years) diagnosed with ODD/CD receiving FAME (n = 11) or TAU (n = 9). Feasibility outcomes of enrollment/attrition, measurement completion, session attendance, and homework completion were assessed using tracking logs and field notes, and acceptability through caregiver satisfaction scores and interviews. Preliminary outcomes were assessed at baseline, post- and 2-months post intervention. Results FAME was highly acceptable and met a priori thresholds for feasibility in enrollment (56%), attrition (35%), caregiver attendance (55%), and homework completion (50%), with lower than anticipated kin attendance (42%) and measurement completion (55%). Preliminary outcomes suggest FAME may benefit caregivers in areas of family communication, cohesion, and quality of life, but lacked observed benefit for self-efficacy and problem solving indicating need for refinement. Conclusion Results inform changes to FAME content, measurement, and delivery schedule in preparation for a fully powered randomized controlled trial.
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    Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents
    (Elsevier, 2018-02) Etter, Dillon J.; McCord, Allison; Ouyang, Fangqian; Gilbert, Amy Lewis; Williams, Rebekah L.; Hall, James A.; Tu, Wanzhu; Downs, Stephen M.; Aalsma, Matthew C.; Pediatrics, School of Medicine
    Purpose The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. Predictors of patient endorsement of suicidality and provider documentation of follow-up were examined. Methods A prospective cohort study was conducted to examine the implementation of a CDSS that screened adolescent patients for suicidality and provided follow-up recommendations to providers. The intervention was implemented for patients aged 12–20 years in two primary care clinics in Indianapolis, Indiana. Results The sample included 2,134 adolescent patients (51% female; 60% black; mean age = 14.6 years [standard deviation = 2.1]). Just over 6% of patients screened positive for suicidality. A positive endorsement of suicidality was more common among patients who were female, depressed, and seen by an adolescent−medicine board-certified provider as opposed to general pediatric provider. Providers documented follow-up action for 83% of patients who screened positive for suicidality. Documentation of follow-up action was correlated with clinic site and Hispanic race. The majority of patients who endorsed suicidality (71%) were deemed not actively suicidal after assessment by their provider. Conclusions Incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care is feasible and well utilized by providers. Female gender and depressive symptoms are consistently associated with suicidality among adolescents, although not all suicidal adolescents are depressed. Universal use of a multi-item suicide screener that assesses recency might more effectively identify suicidal adolescents.