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CLINICAL TRIAL article

Front. Psychiatry
Sec. Public Mental Health
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1446985

Pilot of a Team-Based Quality Improvement Strategy to Improve Cardiovascular Risk Factors Care in Community Mental Health Centers

Provisionally accepted
Karly A Murphy Karly A Murphy 1*Joseph Gennusa Joseph Gennusa 2Arlene T Dalcin Arlene T Dalcin 2Courtney Cook Courtney Cook 2Stacy Goldsholl Stacy Goldsholl 2Tyler Fink Tyler Fink 2Gail Daumit Gail Daumit 2David Thompson David Thompson 2Emma E Mcginty Emma E Mcginty 3
  • 1 University of California, San Francisco, San Francisco, California, United States
  • 2 School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
  • 3 Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, United States

The final, formatted version of the article will be published soon.

    Populations with serious mental illness are less likely to receive evidence-based care for cardiovascular disease (CVD) risk factors. We sought to characterize the implementation of an adapted team-based quality improvement strategy to improve mental health providers' delivery of evidence-based CVD risk factor care.Methods: In a 12-month, single arm pre/post pilot study in four behavioral health homes embedded within psychiatric rehabilitation programs, sites implemented an adapted Comprehensive Unit Safety Program (CUSP). Primary measures examined changes in organizational quality improvement culture and provider self-efficacy for CVD risk factor care. Secondary measures examined changes in acceptability, appropriateness, and feasibility of CUSP and receipt of guideline-concordant care for hypertension, dyslipidemia, and diabetes.Results: Provider self-efficacy to coordinate care for hypertension and diabetes improved, but organizational quality improvement culture did not change. Acceptability, appropriateness, and feasibility were rated highly but did not change pre/post CUSP. The percentage who reached goals per national guidelines improved for those with dyslipidemia but not for those with hypertension or diabetes. CUSP teams implemented processes to build staff capacity, standardize communication, elicit feedback, and deliver education on coordination for CVD risk factors.This pilot study showed no effects of CUSP on organizational quality improvement culture or provider self-efficacy, the mechanisms by which CUSP is expected to improve care processes. Long term investments are needed to support organizational quality improvement work and providers' efficacy to delivery -evidence-based CVD risk factor care delivery.

    Keywords: serious mental illness, cardiovascular risk, Quality Improvement, care coordination, Primary Care, team-based care Word Count: 6, 238 (max word count: 12, 000) References: 54 Figures/Tables: 5 Clinical trial registration: www.ClinicalTrials.gov

    Received: 10 Jun 2024; Accepted: 08 Jan 2025.

    Copyright: © 2025 Murphy, Gennusa, Dalcin, Cook, Goldsholl, Fink, Daumit, Thompson and Mcginty. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Karly A Murphy, University of California, San Francisco, San Francisco, 94143, California, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.