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Papers by Lisa Zerden

Journal of Social Work

Summary The field of social work has seen increased recognition across many sectors in recent yea... more Summary The field of social work has seen increased recognition across many sectors in recent years. Evolving racial, political, and medical paradigms and the COVID-19 pandemic have shown the importance of a person-centered approach to health and mental health. One such area of practice is neurology, specifically work with people with Parkinson's disease (PD), which is the second most common neurodegenerative disease, currently impacting more than 10 million people worldwide. While social workers have long played key roles in multidisciplinary teams in PD care settings, research and literature offering assessment and evidence in this area remain limited. This research study used a mixed-methods approach with additional in-depth qualitative interviews conducted with 11 social workers. This article presents findings from the 11 interviewees who are presently working with people with PD using thematic analysis. Findings Themes emerging were an in-depth detailed role of the social w...

Background Despite recent financial and policy support for harm reduction, little is known about ... more Background Despite recent financial and policy support for harm reduction, little is known about the harm reduction workforce—the specific types of workers within organizations who design, implement, and actualize harm reduction services. This exploratory mixed-methods study asked: (1) Who constitutes the harm reduction workforce? (2) Who provides behavioral health services within harm reduction organizations? (3) Do referrals differ by type of harm reduction worker? Methods Purposive sampling techniques were used to distribute an electronic survey to U.S.-based harm reduction organizations. Descriptive statistics were conducted. Multivariate binary logistic regression models examined the associations (a) between the odds of the referral processes at harm reduction organizations and (b) between the provision of behavioral health services and distinct types of organizational staff. Qualitative data were analyzed using a hybrid approach of inductive and thematic analysis. Results Data...

Societies

Background: Youth from marginalized groups may be less likely to receive quality health care serv... more Background: Youth from marginalized groups may be less likely to receive quality health care services. Adverse Childhood Experiences (ACEs) are known to impact long-term health, but it is unclear if there is a relationship between ACEs and receipt of Family Centered Care (FCC)—one indicator of high-quality health care. To assess this relationship, this study used a nationally representative sample of youth from the National Survey of Children’s Health 2016–2017 combined data set. Caregivers of children who had at least one health care visit in the last 12 months (sub-sample n = 63,662) were asked about five indicators of FCC including if they felt the provider: (1) spent enough time, (2) listened carefully, (3) helped family feel like a partner, (4) provided information requested, and (5) showed sensitivity to culture. Methods: Logistic regression analyses examined the association between ACE score and each FCC quality indicator, as well between ACEs score and the overall FCC dichot...

Workshop Overview: I. Introductions II. Key components and characteristics of interprofessional c... more Workshop Overview: I. Introductions II. Key components and characteristics of interprofessional care III. UNC School of Social Work & training for work in integrated care IV. Meeting the behavioral health needs of transitional-age youth (TAY) and families

Social Work in Mental Health, 2021

ABSTRACT Recent decades have witnessed increases in (a) integrated physical and behavioral health... more ABSTRACT Recent decades have witnessed increases in (a) integrated physical and behavioral health services and (b) the treatment of opioid use disorders (OUD) in primary care settings – also known as office-based opioid treatments (OBOT) – using a combination of medication and psychosocial support. Providing these services requires a workforce trained to address addiction’s psychosocial components and interventions addressing addiction’s biological and neurological mechanisms. This paper examines the implementation factors, clinic workflow and roles, and administrative considerations of two models of integrated care in order to identify ways of increasing treatment capacity and expanding OUD treatment uptake in integrated primary care settings.

Advances in Social Work, 2020

Interprofessional education (IPE) “occurs when students from two or more professions learn about,... more Interprofessional education (IPE) “occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” (World Health Organization [WHO], 2010). With a commitment to foster collaborative practice, social work faculty have provided leadership in incorporating IPE in social work and other discipline’s curricula and training for more than a decade (Konrad et al., 2017; Nimmagadda & Murphy, 2014; Jones & Phillips, 2016). Yet, now more than ever, as the country and world grapple with responding to the COVID-19 pandemic and the resultant deleterious impacts on society, effective collaboration has never been more critical. Likewise, the Black Lives Matter (BLM) movement has impacted the nation as the country reckons with racial and social disparities across every sector of society. The impetus for this special issue pre-dated the COVID-19 and BLM momentum; however, the 19 papers included in this special issue...

Journal of Social Work Education, 2019

The call for professional education programs to clarify the standards students are held accountab... more The call for professional education programs to clarify the standards students are held accountable to is particularly challenging for social work. For social work educators, tackling this task not only involves grappling with their role as gatekeepers to the profession but also ensuring that such standards preserve the profession's commitment to accessibility in the student body. This article describes the process and lessons learned at one graduate school of social work who developed and implemented technical standards for professional and ethical behavior for MSW students. The challenges articulating professional standards for students beginning their social work education are shared and the discussion serves as a guide to inform the future development and implementation of similar standards across social work programs.

Journal of Evidence-Informed Social Work, 2015

Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and... more Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

Journal of Evidence-Based Social Work

Purpose: Social work (SW) is a profession that fulfills important roles on integrated health team... more Purpose: Social work (SW) is a profession that fulfills important roles on integrated health teams, yet there remains a lack of clarity on SW's functions. The current study sought to identify typologies of SW's roles on integrated care teams using latent class analysis (LCA).Method: An electronic survey was developed, piloted, and administered to Masters level SW students and practitioners in integrated health care settings (N = 395) regarding weekly use of interventions. LCA was conducted to estimate latent sub-groups of respondents.Results: Respondents reported an average of 14.6 (SD = 4.7) interventions. Five classes of SW roles were identified and varied by setting and focus. One class (13%) completed a hybrid function providing behavioral health and social care interventions.Conclusions: Classes of SW roles on teams may reflect varying models of integrated care. A flexible SW on the team may adapt to patient and clinic needs, but increases the opportunity for role confusion.

Social Work in Health Care

Journal of the Society for Social Work and Research, 2022

The COVID-19 pandemic disrupted access to and the delivery of behavioral health services for soci... more The COVID-19 pandemic disrupted access to and the delivery of behavioral health services for social work providers and their clients. This study examined the use of tele-behavioral health by social workers before and during the pandemic, as well as the perceived barriers and supports to technology use. Method: We developed an electronic survey, which was distributed to a convenience sample of practicing social work professionals in the United States through a national listserv. A mixed-methods study design was used to analyze responses (N 5 585). Results: Over 92% of social workers reported using tele-behavioral health since the beginning of the pandemic, compared to 28% prior. About half of respondents received training on tele-behavioral health since COVID-19, whereas only 23% had received training prior. The vast majority (87%) indicated one or more barriers to the use of tele-behavioral health, with client barriers (73%) being the area of greatest concern. Yet, social workers overwhelmingly reported the desire for telebehavioral health to continue beyond the pandemic. Conclusions: Based on our findings, we propose the following recommendations: (a) Ensure parity and reimbursement for tele-behavioral health; (b) train current and future social work practitioners in tele-behavioral health; and (c) provide supports for client use of tele-behavioral health.

Journal of Health and Human Services Administration, 2021

Purpose: To identify the strategies and interventions U.S. health systems implemented to reduce b... more Purpose: To identify the strategies and interventions U.S. health systems implemented to reduce burnout and increase employee well-being during the first year of the COVID-19 pandemic. Methods: A concurrent design included a scoping review of published literature on burnout interventions implemented for healthcare workers during COVID-19 and expert interviews with healthcare administrators involved in COVID-19 burnout response efforts (N = 5). Scoping review protocols included a-priori inclusion criteria, search terms, database selection, and data abstraction (N = 21 articles). Results: The scoping review identified eight types of interventions; spanning individual, organizational, and community systems. Qualitative data supported scoping review findings and uncovered themes related to communication, role shifting, and wellness initiatives as forms of burnout prevention and reduction. Conclusion: As COVID-19 continues, so too will worker stress, burden, and burnout. Health systems w...

Our Model: Designed by Students for Students • Independent study with 6-7 health professions grad... more Our Model: Designed by Students for Students • Independent study with 6-7 health professions graduate students • Faculty mentors • Students developed objectives, learning activities, and designed modules • Content validity • Students were our best recruiters for the fall

Handbook of Health Social Work, 2019

Social Work in Public Health, 2021

The objective of this study was to determine how well Electronic Health Record (EHR) documentatio... more The objective of this study was to determine how well Electronic Health Record (EHR) documentation identifies which health professionals act to address patient social determinants of health (SDOH) and what interventions are documented. The Electronic Medical Record Search Engine was used to identify food and housing insecurity EHR notes. From the notes, researchers randomly sampled 60 from each SDOH category. Of 120 notes, which contained a reference to food or housing insecurity, 72% also contained information on an intervention taken. Interventions were documented by social workers 63% of the time, followed by dietitians and physicians. Addressing patient SDOH is a crucial part of comprehensive healthcare. Findings contribute to a broader conversation on the documentation and interventions in healthcare settings to address patients' SDOH. Findings support the critical importance of standardizing SDOH documentation in the EHR across more members of the health workforce to ensure patient needs are met.

Families, Systems, & Health, 2021

INTRODUCTION Integrated health care is utilized in primary care clinics to meet patients' phy... more INTRODUCTION Integrated health care is utilized in primary care clinics to meet patients' physical, behavioral, and social needs. Current methods to collect and evaluate the effectiveness of integrated care require refinement. Using informatics and electronic health records (EHR) to distill large amounts of clinical data may help researchers measure the impact of integrated care more efficiently. This exploratory pilot study aimed to (a) determine the feasibility of using EHR documentation to identify behavioral health and social care components of integrated care, using social work as a use case, and (b) develop a lexicon to inform future research using natural language processing. METHOD Study steps included development of a preliminary lexicon of behavioral health and social care interventions to address basic needs, creation of an abstraction guide, identification of appropriate EHR notes, manual chart abstraction, revision of the lexicon, and synthesis of findings. RESULTS Notes (N = 647) were analyzed from a random sample of 60 patients. Notes documented behavioral health and social care components of care but were difficult to identify due to inconsistencies in note location and titling. Although the interventions were not described in detail, the outcomes of screening, referral, and brief treatment were included. The integrated care team frequently used EHR to share information and communicate. DISCUSSION Opportunities and challenges to using EHR data were identified and need to be addressed to better understand the behavioral health and social care interventions in integrated care. To best leverage EHR data, future research must determine how to document and extract pertinent information about integrated team-based interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Journal of Social Work Education, 2020

ABSTRACT Evidence shows that when an interprofessional (IP) approach is effectively implemented, ... more ABSTRACT Evidence shows that when an interprofessional (IP) approach is effectively implemented, it can counteract some of our most pressing health care problems. One such challenge is the lack of training in IP teamwork health care professionals receive during their education. Using a quasi-experimental matched comparison group design, this study assessed pre- and posttest changes in IP knowledge, attitudes, and skills of MSW students (N = 52) from 2015–2017, who received a specialized curriculum, and clinical internships working in IP teams, compared to an internal control group involving clinical IP teams alone. Two validated measures assessed changes in students’ IP knowledge, values, and skills. Quantitative findings and qualitative responses to open-ended questions elucidate barriers and facilitative factors in IP teams.

Families, Systems, & Health, 2020

INTRODUCTION Evidence supports that integrated behavioral health care improves patient outcomes. ... more INTRODUCTION Evidence supports that integrated behavioral health care improves patient outcomes. Colocation, where health and behavioral health providers work in the same physical space, is a key element of integration, but national rates of colocation are unknown. We established national colocation rates and analyzed variation by primary care provider (PCP) type, practice size, rural/urban setting, Health and Human Services region, and state. METHOD Data were from the Centers for Medicare & Medicaid Services' 2018 National Plan and Provider Enumeration System data set. Practice addresses of PCPs (family medicine, general practitioners, internal medicine, pediatrics, and obstetrician/gynecologists), social workers, and psychologists were geocoded to latitude and longitude coordinates. Distances were calculated; those < 0.01 miles apart were considered colocated. Bivariate and multivariate analyses were conducted, and maps were generated. RESULTS Of the 380,690 PCPs, > 44% were colocated with a behavioral health provider. PCPs in urban settings were significantly more likely to be colocated than rural providers (46% vs. 26%). Family medicine and general practitioners were least likely to be colocated. Only 12% of PCPs who were the sole PCP at an address were colocated compared with 48% at medium-size practices (11-25 PCPs). DISCUSSION Although colocation is modestly expanding in the United States, it is most often occurring in large urban health centers. Efforts to expand integrated behavioral health care should focus on rural and smaller practices, which may require greater assistance achieving integration. Increased colocation can improve access to behavioral health care for rural, underserved populations. This work provides a baseline to assist policymakers and practices reach behavioral health integration. (PsycInfo Database Record (c) 2020 APA, all rights reserved).