Measuring Productivity in Primary Care Behavioral Health: A Delphi Study

High productivity by behavioral health consultants (BHC) is a defining aspect of the primary care behavioral health (PCBH) model to maximize access to care and is often measured by patient volume. Studies of productivity in health care settings suggest a single productivity target may not be optimal. We used a Delphi method to obtain expert consensus on an operational definition of high productivity by BHCs in the PCBH model. Clinicians, managers, and researchers in PCBH were recruited to participate in a multi-round survey using a modified Delphi technique and develop consensus on PCBH productivity metrics. Ten participants completed all three survey rounds and rated 28 metrics. After three rounds, two direct metrics (average number of billable BHC visits each day; number of patients seen per day) received at least 80% consensus as “Essential”, two received at least 50%, and five received less than 50%. One influencer (level of integration at the practice) received at least 80% consensus as “Very Much” influential, 19 received at least 50%, and eight items received less than 50%. Several themes arose from participant comments. PCBH productivity can be interpreted as being high volume. Numerous practice factors influence how productive a BHC may be. Future studies should determine the feasibility of our metrics in clinical practice, establish productivity expectations based on patient needs and clinic resources, and identify patient-, clinician-, or practice-level moderators of productivity.

     

Psychological Wellbeing,Dyadic Adjustment,and Parental Stress among Spanish Families during the COVID-19 Outbreak

Journal of Child and Family Studies - Due to COVID-19, many countries, like Spain, imposed lockdown on the entire population to prevent the virus from spreading. The purpose of this exploratory...     

Interparental Conflict Appraisals and Adolescents’ Maladaptation in Siblings: An Actor-Partner Interdependence Model

Journal of Child and Family Studies - The aim of this study was to evaluate dyadic effects among siblings by testing an actor–partner interdependence model of associations between...     

Humor Styles,Perceived Threat,Funniness of COVID-19 Memes,and Affective Mood in the Early Stages of COVID-19 Lockdown

Existing psychological research has long considered humor as a useful strategy for individuals in coping with adverse circumstances and life stressors. However, empirical studies are called for to better understand the role of humor in facing the COVID-19 pandemic. In a community sample of 527 Spanish adults, we investigated the associations between humor styles, perceived threat from COVID-19, funniness of COVID-19 memes, and individuals’ affective mood. Data were collected during the third week of lockdown in Spain (from 26 to 31 March 2020). Our results suggest that intrapsychic humor styles were associated with better coping with the COVID-19 pandemic. Structural equation modelling showed that self-enhancing and aggressive humor styles were related to perceiving COVID-19 as less psychologically threatening, which, in turn, was associated with a greater perceived funniness of COVID-19 memes, thus predicting higher levels of happiness. Interestingly, the opposite pattern of connections was found for self-defeating humor. These findings suggest that humor styles aimed at boosting one’s own self, irrespective of their potentially lighter or darker nature, may contribute to alleviating adverse psychological consequences arising from the COVID-19 pandemic.

     

Tradition religieuse et capacité de pardon

Forgiveness is a fundamental ingredient of everyday life. This article is intended to present, in a synthetic way, a number of recent works having empirically determined the relationship between religious tradition and forgivingness. To forgive is basically to give something to someone. For/give is the equivalent of the latin per/donare. Forgiveness is the gift of one's right to resentment after having been the victim of an offense. Forgiveness has been empirically investigated in two ways. The first approach specifically considered forgiveness as a possible answer to a given situation. The second approach considered forgiveness as a philosophy of life, as a habit; that is, as a personality trait. The studies reported in this article illustrate this second approach. A three-factor model of forgivingness is presented: lasting resentment, sensitivity to the circumstances of the offence, and unconditional forgiveness. It is shown that this model nicely fit empirical data from samples of persons grown up either in the Buddhist tradition, or in the Christian tradition, or in the Hindu tradition. It is also shown that among people grown up in the Muslim tradition this model must be adjusted to reflect the unique character of this tradition: Islam is both a religious and a political tradition. In brief, people whose spiritual references are either Buddhist or Christian or Hindu must be aware that if a conflict, even a minor one, opposes them to Muslims, a particular attention will be attributed to their apologizing behavior and to their efforts to repair the wrong committed. Forgiveness will probably be granted only after the offender has satisfied a number of conditions. Symmetrically, people whose references are Muslim must be aware that, if a conflict opposes them to people grown up in the other traditions, all the circumstances of the situation will probably play a more or less similar role (intention, apology, social proximity) and that forgiveness may be unconditionally granted. Unconditional forgiveness exists, at least in theory, in these traditions: it is not regarded as a weakness or as an immoral disposition.     

Not just playing around: Infants’ behaviors with objects reflect ability,constraints, and object properties

This study describes infants’ behaviors with objects in relation to age, body position, and object properties. Object behaviors were assessed longitudinally in 22 healthy infants supine, prone, and sitting from birth through 2 years. Results reveal: (1) infants learn to become intense and sophisticated explorers within the first 6 months of life; (2) young infants dynamically and rapidly shift among a variety of behavioral combinations to gather information; (3) behaviors on objects develop along different trajectories so that behavioral profiles vary across time; (4) object behaviors are generally similar in supine and sitting but diminished in prone; and (5) infants begin matching certain behaviors to object properties as newborns. These data demonstrate how infants learn to match their emerging behaviors with changing positional constraints and object affordances.     

Individual differences in timing of discrete and continuous movements: a dimensional approach

This study investigated aspects of individual differences in timing of continuous and discontinuous movements to different pacing signals (auditory or visual), pacing intervals (500, 650, 800, 950 ms), and across effectors (dominant versus non-dominant hand). Correlation and principal component analysis demonstrated that a single statistical dimension accounted for up to 60 % of the explained variance in discontinuous tasks and 25 % of the variance in continuous tasks, when applied to performance obtained from tasks conducted with different effectors and at different pacing rates. Correlation analysis of factor scores representing effector and rate independent task performances showed that timing of discrete or continuous movements can be associated with modality independent mechanisms. Timing variability from discrete and continuous trials was not significantly correlated. This study goes beyond previous correlational work on individual differences in discrete and continuous movements, demonstrating that individual differences in discrete (event-based) or continuous (emergent) motor timing tasks can be modeled as distinctive statistical components with dissimilar capability to capture effector, rate, and modality independent variance.     

The role of working memory in inferential sentence comprehension

Existing literature on inference making is large and varied. Trabasso and Magliano (Discourse Process 21(3):255–287, 1996) proposed the existence of three types of inferences: explicative, associative and predictive. In addition, the authors suggested that these inferences were related to working memory (WM). In the present experiment, we investigated whether WM capacity plays a role in our ability to answer comprehension sentences that require text information based on these types of inferences. Participants with high and low WM span read two narratives with four paragraphs each. After each paragraph was read, they were presented with four true/false comprehension sentences. One required verbatim information and the other three implied explicative, associative and predictive inferential information. Results demonstrated that only the explicative and predictive comprehension sentences required WM: participants with high verbal WM were more accurate in giving explanations and also faster at making predictions relative to participants with low verbal WM span; in contrast, no WM differences were found in the associative comprehension sentences. These results are interpreted in terms of the causal nature underlying these types of inferences.