Kenneth B Wells
Biographic Data
| ID | 126170 |
|---|---|
| NAME | Kenneth B Wells |
| GIVEN NAMES | Kenneth B |
| FAMILY NAME | Wells |
| SIGNATURE | WELLS K B |
| AFFILIATIONS | RAND Corporation |
| ORCID | 0000-0002-7454-6589 |
| VERIFIED | Yes |
| TOTAL WORKS | 93 |
| TOTAL CITATIONS | 196 |
| AUTHOR COUNT | 93 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1984 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 8 |
Contextualizing the mental health help‐seeking behaviors of Latina college students experiencing suicidal thoughts or behaviors: A qualitative inquiry from multiple perspectives
Latina college students are at a heightened risk for suicidal thoughts and behaviors (STBs) linked to intersectional stressors such as gendered and racial discrimination. Although many express an openness to help-seeking, they often face barriers to accessing and remaining engaged in formal mental health services and, alternatively, lean more heavily on informal supportive systems such as family members and peers. This qualitative descriptive stu…
Impact of Veteran Journeys opera on audience member attitudes related to veterans with posttraumatic stress or unstable housing
Live Opera Performances on Veteran Recovery from Homelessness and Post Traumatic Stress: Post- Discussion Qualitative Analysis
There is limited research on the impact of art forms, including opera, on audience and cast engagement in understanding mental health needs and support for Veterans at risk for post-traumatic stress disorder (PTSD) and homelessness. This qualitative study explores post-performance discussions from audience and cast members after live performances of an opera about Vietnam Veterans and family members, and their experiences of war-time trauma, hous…
Community Leadership Institute for Equity: Planning Processes and Procedures to Develop Partnered Conferences
It was feasible to use CPPR to plan Zoom conferences to promote community leadership training across multiple sites. Key planning themes included promoting equity, addressing structural racism, bidirectional learning and integrating community, academic, and policy priorities with community co-leaders as change agents
Impact of Opera on Resilience and Thriving in Serious Mental Illness: Pilot Evaluation of The Center Cannot Hold Part 2 and Resilience Workshop
There are few studies of impacts of arts on recovery in schizphrenia, on audience mood and social connection. We developed a pilot evaluation of opera performances in a university setting on Elyn Saks' journey from psychosis, teaching law and falling in love, coupled with pre-opera workshop on approaches to resilience. Using surveys, primary outcomes were pre and post affect (PANAS-X positive, negative; visual "affect grid" touchscreen for affect…
Formative Evaluation of Post-Opera Live Discussion of the Center Cannot Hold Part 2 and Resilience Workshop
There are few studies of impacts of arts on recovery in schizophrenia, on audience and cast responses. We developed a formative qualitative evaluation of audience and cast discussions after viewing live performances in a university setting of an opera based on Elyn Saks' journey from psychosis, teaching law and falling in love, coupled with pre-opera workshop on community approaches to resilience. Live discussions were conducted with audience, ca…
Patterns of Health Care Access and Use in an Urban American Indian and Alaska Native Population
Using Community-Partnered Participatory Research to Value the “Community Lens” and Promote Equity in Community–Academic Partnerships
Background: Community input is crucial for identifying characteristics necessary for equitable, sustainable community-academic partnerships (CAPs). A November 2021 conference, honoring the late Dr. Loretta Jones and the Community-Partnered Participatory Research (CPPR) model, was held to gather input for designing a learning institute for community members as co-equal partners with academics in research, program, and policy initiatives. This crea…
An Integrative Review of Community-Based Mental Health Interventions Among Resettled Refugees from Muslim-Majority Countries
Resettled refugees from Muslim-majority countries are underrepresented in research and meeting their mental health needs remains a challenge for countries of resettlement. In this integrative review, we synthesize community-based mental health interventions using an ecological framework. Eleven relevant studies were identified using PubMed and PsychInfo database. Most interventions focus on micro-system level factors like promoting integration an…
Regional Research-Practice-Policy Partnerships in Response to Climate-Related Disparities: Promoting Health Equity in the Pacific
Although climate change poses a threat to health and well-being globally, a regional approach to addressing climate-related health equity may be more suitable, appropriate, and appealing to under-resourced communities and countries. In support of this argument, this commentary describes an approach by a network of researchers, practitioners, and policymakers dedicated to promoting climate-related health equity in Small Island Developing States an…
Multi-Sector Assessment and Client-Perception of Social Need at Long-Term Follow-Up of a Group-Randomized Trial of Community-Engaged Collaborative Care for Adults with Depression
Understanding client perceptions of need for underlying social determinant support may improve services for depression care. This secondary analysis examines perceptions of "social needs" related to housing and employment, financial, and legal (EFL) concerns among individuals with depression. Data were analyzed from Community Partners in Care, a randomized comparative effectiveness trial of multi-sector collaborative care for depression among a s…
Communities for Wellness Equity: Implementing a Partnered Symposium to Identify Social Determinants of Health Priorities
Using CPPR to gain community members' insight about local factors that drive individual and community health is feasible and viewed by the community as socially responsible, suggesting it holds promise to address root causes of health inequality in under-resourced communities
A Rapid Assessment of Disaster Preparedness Needs and Resources during the Covid-19 Pandemic
Background: This year has seen the emergence of two major crises, a significant increase in the frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in respondin…
Impact of Opera on Mental Health Stigma: Pilot of Provider/Community Workshop
The pre- to post increase in audience willingness to engage with affected persons (primary) with greater impact on secondary mediators for the schizophrenia opera and post-discussion suggest that operas may be a forum for addressing mental health stigma and promoting empathy
Engaging Community Networks to Improve Depression Services: A Cluster-Randomized Trial of a Community Engagement and Planning Intervention
Community Interventions to Promote Mental Health and Social Equity
PURPOSE OF REVIEW: We review recent community interventions to promote mental health and social equity. We define community interventions as those that involve multi-sector partnerships, emphasize community members as integral to the intervention, and/or deliver services in community settings. We examine literature in seven topic areas: collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental …
Community Engagement and Planning versus Resources for Services for Implementing Depression Quality Improvement: Exploratory Analysis for Black and Latino Adults
Exploratory analyses of CEP for depression quality improvement suggests significant 6-month benefits in mental health outcomes for Black and Latino participants and trends for improvement in community-prioritized outcomes for both groups. Findings may inform research in multi-sector coalitions to promote equity in depression care
Medicaid Utilization Before and After a Natural Disaster in the 2016 Baton Rouge–Area Flood
Objectives. To understand changes in behavioral health services utilization and expenditures before and after natural disaster with an adult Medicaid population affected by the Baton Rouge, Louisiana–area flood (August 2016). Methods. We examined de-identified behavioral health claims data for Medicaid-insured adults in the affected region for 10 months before and after flooding (October 2015–June 2017). This constituted 273 233 provider claims f…
Preparedness and Community Resilience in Disaster-Prone Areas: Cross-Sectoral Collaborations in South Louisiana, 2018
Objectives. To determine how community-based organizations (CBOs) define priorities for bolstering community resilience, challenges in addressing these priorities, and strategies to address challenges. Methods. The Community Resilience Learning Collaborative and Research Network (C-LEARN) is a multiphase study examining opportunities to improve community resilience to the threats of disaster and climate change in South Louisiana. Phase I of C-LEA…
High Quality of Care Persists With Shifting Depression Services From VA Specialty to Integrated Primary Care
BACKGROUND/OBJECTIVE: Offering depression collaborative care services in primary care (PC) settings can reduce use of nonintegrated mental health care resources and improve mental health care access, particularly for vulnerable PC patients. Tests of effects on depression care quality, however, are needed. We examined overall quality of depression care and tested whether increasing clinic engagement in Veterans Affairs (VA)'s Primary Care-Mental H…
Community Resilience Learning Collaborative and Research Network (C-Learn): Study Protocol with Participatory Planning for a Randomized, Comparative Effectiveness Trial
This manuscript presents the protocol and participatory planning process for implementing the Community Resilience Learning Collaborative and Research Network (C-LEARN) study. C-LEARN is designed to determine how to build a service program and individual client capacity to improve mental health-related quality of life among individuals at risk for depression, with exposure to social risk factors or concerns about environmental hazards in areas of…
Evaluating Community Partnerships Addressing Community Resilience in Los Angeles, California
Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure the number, type, and quality of relationships among organizations participating in 16 coalitions brought together to address community resilience…
Case Study of Resilient Baton Rouge: Applying Depression Collaborative Care and Community Planning to Disaster Recovery
Our partnered processes and lessons learned may be applicable to other communities that aim to promote resilience, as well as planning for and responding to post-disaster behavioral health needs
A Window of Opportunity: Visions and Strategies for Behavioral Health Policy Innovation
The advisory meeting suggested that local policy makers, academics, and community members, together with federal agents, are working to implement behavioral health policy innovation
Maintaining Internal Validity in Community Partnered Participatory Research: Experience from the Community Partners in Care Study
Objective: With internal validity being a central goal of designed experiments, we seek to elucidate how community partnered participatory research (CPPR) impacts the internal validity of public health comparative-effectiveness research.Methods: Community Partners in Care (CPIC), a study comparing a community-coalition intervention to direct technical assistance for disseminating depression care to vulnerable populations, is used to illustrate …
The importance of social context: Neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders
Emotional and behavioral problems and severe academic delays among sheltered homeless children in Los Angeles County
OBJECTIVES. Few studies have estimated the extent of specific emotional, behavioral, and academic problems among sheltered homeless children. The objectives of this study were to describe such problems, identify those children with the problems, and evaluate the relationship between child problems and use of physical and mental health services. METHODS. From February through May 1991, 169 school-age children and their parents living in 18 emergen…
The Teen Photovoice Project: A Pilot Study to Promote Health Through Advocacy
Youth can engage in a process of identifying community-level health influences, leading to health promotion through advocacy. Participants focused their advocacy work on selected issues addressing the types of unhealthy food available in their communities and stress. This process appears to provide meaningful insight into the youths' perspective on what influences their health behaviors
Somatization in the community: Relationship to disability and use of services
We tested the hypotheses that an abridged somatization construct that we had developed would be associated with use of health services, preferential use of medical over mental health services, and an index of disability. These hypotheses were tested using structured interview data from 3,132 randomly selected community respondents. We found that: respondents meeting criteria for somatization reported a heavier use of health services than non-soma…
Getting Actionable About Community Resilience: The Los Angeles County Community Disaster Resilience Project
Community resilience (CR)—ability to withstand and recover from a disaster—is a national policy expectation that challenges health departments to merge disaster preparedness and community health promotion and to build stronger partnerships with organizations outside government, yet guidance is limited. A baseline survey documented community resilience–building barriers and facilitators for health department and community-based organization (CBO) …
Building Community Disaster Resilience: Perspectives From a Large Urban County Department of Public Health
An emerging approach to public health emergency preparedness and response, community resilience encompasses individual preparedness as well as establishing a supportive social context in communities to withstand and recover from disasters. We examine why building community resilience has become a key component of national policy across multiple federal agencies and discuss the core principles embodied in community resilience theory—specifically, …
Applying Community Engagement to Disaster Planning: Developing the Vision and Design for the Los Angeles County Community Disaster Resilience Initiative
Community resilience (CR) is a priority for preparedness, but few models exist. A steering council used community-partnered participatory research to support workgroups in developing CR action plans and hosted forums for input to design a pilot demonstration of implementing CR versus enhanced individual preparedness toolkits. Qualitative data describe how stakeholders viewed CR, how toolkits were developed, and demonstration design evolution. Sta…
The practices of general and subspecialty internists in counseling about smoking and exercise
We compared the practices of subspecialists and general internists in counseling about smoking and exercise, using data from a study of recent graduates of United States training programs in internal medicine. Information on the characteristics of physicians and their clinical practices was obtained from self-report questionnaires. The internists most likely to counsel smokers regardless of the presence or absence of diseases associated with smok…
Using Community Arts Events to Enhance Collective Efficacy and Community Engagement toAddress Depression in an African American Community
Objectives. We used community-partnered participatory research (CPPR) to measure collective efficacy and its role as a precursor of community engagement to improve depression care in the African American community of South Los Angeles. Methods. We collected survey data from participants at arts events sponsored by a CPPR workgroup. Both exploratory (photography exhibit; n = 747) and confirmatory (spoken word presentations; n = 104) structural equ…
Impact of Opera on Mental Health Stigma: Pilot of Provider/Community Workshop
The pre- to post increase in audience willingness to engage with affected persons (primary) with greater impact on secondary mediators for the schizophrenia opera and post-discussion suggest that operas may be a forum for addressing mental health stigma and promoting empathy
Community Engagement Compared With Technical Assistance to Disseminate Depression Care Among Low-Income, Minority Women: A Randomized Controlled Effectiveness Study
Objectives. To compare the effectiveness of a (CEP) versus a technical assistance approach (Resources for Services, or RS) to disseminate depression care for low-income ethnic minority women. Methods. We conducted secondary analyses of intervention effects for largely low-income, minority women subsample (n = 595; 45.1% Latino and 45.4% African American) in a matched, clustered, randomized control trial conducted in 2 low-resource communities in …
The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking
Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened posit…
Preparedness and Community Resilience in Disaster-Prone Areas: Cross-Sectoral Collaborations in South Louisiana, 2018
Objectives. To determine how community-based organizations (CBOs) define priorities for bolstering community resilience, challenges in addressing these priorities, and strategies to address challenges. Methods. The Community Resilience Learning Collaborative and Research Network (C-LEARN) is a multiphase study examining opportunities to improve community resilience to the threats of disaster and climate change in South Louisiana. Phase I of C-LEA…
The Teen Photovoice Project: A Pilot Study to Promote Health Through Advocacy
Medicaid Utilization Before and After a Natural Disaster in the 2016 Baton Rouge–Area Flood
Objectives. To understand changes in behavioral health services utilization and expenditures before and after natural disaster with an adult Medicaid population affected by the Baton Rouge, Louisiana–area flood (August 2016). Methods. We examined de-identified behavioral health claims data for Medicaid-insured adults in the affected region for 10 months before and after flooding (October 2015–June 2017). This constituted 273 233 provider claims f…
Response to Ellis and McGuire: "Cost sharing and the demand for ambulatory mental health services"
Health status and the use of outpatient mental health services
Using data from the RAND Corporation's Health Insurance Study, the authors have linked mental health status (self-reported psychological distress and psychological well-being) to the subsequent use outpatient mental health services delivered by formally trained mental health specialists and general medical providers
Cost sharing and the use of ambulatory mental health services
Used preliminary data from the Rand Corporation's Health Insurance Study to examine expenditures for ambulatory mental health services (MHSs) based on a sample of 4,444 families (at initial enrollment) of the nonelderly, noninstitutionalized civilian population. Selected findings reveal that reducing the level of cost sharing increases the demand for MHSs; the response to cost sharing is roughly the same for ambulatory medical and MHSs
Physicians?? Practices in Counseling Patients About Health Habits
The authors developed and tested a model of two dimensions of physicians' behavior in counseling patients about four health habits (smoking, weight control, alcohol consumption, and regular exercise). The two dimensions are the indications for routine counseling and the aggressiveness of counseling style. To test these dimensions, a questionnaire was administered to a random sample of members of a Western County Medical Society in 1978. The respo…
Physicians?? Attitudes in Counseling Patients About Smoking
Attitudes of physicians toward counseling patients about their smoking habits may influence whether and how counseling occurs. In this paper, the authors develop and test a conceptual model of these attitudes. The model includes four attitude dimensions: physicians' motivations to counsel, perceived health risk of smoking, perceived skills in counseling, and perceived costs and benefits to the physician of counseling. A self-report questionnaire …
The Sensitivity of Mental Health Care Use and Cost Estimates to Methods Effects
The authors determined the sensitivity of estimates of the use and cost of outpatient mental health care to two methods effects: the definition of a mental health visit and strategies for allocating mental health care costs. They use data from the Rand Health Insurance Study, which has a random sample of the nonaged noninstitutionalized civilian population in six United States sites. Estimates of the use of mental health specialists are insensiti…
Career Orientations of Medical and Pediatric Residents
Educators have expressed concern about the declining percentage of graduating residents who choose an academic career. This study identifies characteristics of postgraduate physicians that are associated with intentions to pursue an academic career or a full-time private practice. Data were obtained from 299 residents in pediatrics and internal medicine at five academic medical centers in Southern California, using self-report questionnaires. Pre…
Health Status, Sociodemographic Factors, and the Use of Prescribed Psychotropic Drugs
The relations among sociodemographic factors, health status, and use of prescribed sleeping pills and tranquilizers are examined. The data are from the Rand Health Insurance Experiment, which has a random sample of the nonaged, noninstitutionalized, civilian population in six U.S. sites. Information on sociodemographic factors, health status, and the use of prescribed psychotropic drugs during the previous 3 months was obtained from self-report q…
The practices of general and subspecialty internists in counseling about smoking and exercise
We compared the practices of subspecialists and general internists in counseling about smoking and exercise, using data from a study of recent graduates of United States training programs in internal medicine. Information on the characteristics of physicians and their clinical practices was obtained from self-report questionnaires. The internists most likely to counsel smokers regardless of the presence or absence of diseases associated with smok…
A Comparison of the Effects of Sociodemographic Factors and Health Status on Use of Outpatient Mental Health Services in HMO and Fee-for-service Plans
The authors compared the effects of age, sex, socioeconomic status, and mental and physical health status on the use of outpatient mental health services in one well-established health maintenance organization (HMO) and in fee-for-service plans. In the Seattle site of the Rand Health Insurance Study (HIS), families were randomly assigned to HMO or fee-for-service coverage. Adults incur much greater expense for outpatient mental health services th…
Sociodemographic Factors and the Use of Outpatient Mental Health Services
What are the effects of sociodemographic factors on the use of outpatient mental health services when different demographic groups have identical health insurance coverage? The authors answer this question using data from the Rand Health Insurance Experiment. Health insurance was randomly assigned to families representative of the nonaged, noninstitutionalized civilian population in six U.S. sites. Income has no significant total effect on use wh…
Somatization in the community: Relationship to disability and use of services
We tested the hypotheses that an abridged somatization construct that we had developed would be associated with use of health services, preferential use of medical over mental health services, and an index of disability. These hypotheses were tested using structured interview data from 3,132 randomly selected community respondents. We found that: respondents meeting criteria for somatization reported a heavier use of health services than non-soma…
Comparison of Use of Outpatient Mental Health Services in an HMO and Fee-for-Service Plans: Sensitivity to Definition of a Visit
Whereas previous authors have used a variety of strategies to identify use of mental health services, the sensitivity of estimates to the definition of a visit has been little studied. The authors examined the sensitivity of estimates of use of outpatient mental health services in both HMO and fee-for-service plans to the method of identifying outpatient mental health visits. The HMO and fee-for-service plans had identical benefits (i.e., free ca…
Factors Affecting the Probability of Use of General and Medical Health and Social/Community Services for Mexican Americans and Non-Hispanic Whites
Are individual characteristics associated with use of general and mental health and human service sectors similar for Mexican Americans (MAs) and non-Hispanic whites (NHWs)? We addressed this question using data from the Los Angeles site of the NIMH Epidemiologic Catchment Area Program. A random sample of the general population of two mental health catchment areas was interviewed in 1983-1984. With four exceptions, individual variation in sociode…
Development of a Brief Screening Instrument for Detecting Depressive Disorders
A very short (8-item), self-report measure was developed to screen for depressive disorders (major depression and dysthymia). The screener departs from traditional depressive symptom scales in that 1) individual items are differentially weighted and 2) two of the eight items concern diagnostically-relevant durations of depressed mood. Analyses of data from a general population and from primary care and mental health patients showed that the scree…
Management of Patients on Psychotropic Drugs in Primary Care Clinics
While nonpsychiatrist physicians account for the majority of prescriptions written for psychotropic drugs, little is known about the quality of their drug management strategy. We studied this issue using data from 16 academic internal medicine group practices. Data on treatment, abstracted from medical records, were compared to criteria for quality care. Eighteen percent of patients used minor tranquilizers or antidepressants. The only individual…
The Functioning and Well-being of Depressed Patients: Results From the Medical Outcomes Study
We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11 242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodi…
The preparedness of freshman medical students for taking sexual histories
Mental Health and Selection of Preferred Providers: Experience in Three Employee Groups
While Preferred Provider Organizations (PPOs) are designed to contain the costs of health care, they may not be able to do so if sicker individuals opt not to use PPO providers. This study examined how level of mental health status and prior use of mental health services affected the decision to use or not use PPO providers for mental health care for employees enrolled in fee-for-service plans with a PPO option. Data were obtained from an employe…
The Effects of Psychological Distress and Psychological Well-Being on Use of Medical Services
In this study, the authors determined whether mental health status affects the use of general medical services, with and without adjustment for the correlated effects of general health perceptions and physical health status on such use. Data were used from the RAND Health Insurance Experiment, which has information on up to 5 years of use of medical services by a nonelderly, civilian, general population. Health status and other covariates were as…
The Effects of Preferred Provider Options in Fee-For-Service Plans on Use of Outpatient Mental Health Services by Three Employee Groups
Descriptions of how preferred provider organizations (PPOs), offered as options to employees enrolled in fee-for-service plans, affected use of outpatient mental health services are provided. Data are from the RAND Preferred Provider Organization Study, which has a sample of employees who enrolled in fee-for-service plans 1 year before and 2 years after a PPO option was offered by three employers in two U.S. sites. To study effects of the optiona…
Emotional and behavioral problems and severe academic delays among sheltered homeless children in Los Angeles County
OBJECTIVES. Few studies have estimated the extent of specific emotional, behavioral, and academic problems among sheltered homeless children. The objectives of this study were to describe such problems, identify those children with the problems, and evaluate the relationship between child problems and use of physical and mental health services. METHODS. From February through May 1991, 169 school-age children and their parents living in 18 emergen…
Quality of Care for Depressed Elderly Pre-Post Prospective Payment System: Differences in Response Across Treatment Settings
We evaluated the quality of care for depressed elderly patients (n = 2,746) hospitalized in general medical hospitals (n = 297) before or after implementation of Medicare's Prospective Payment System, focusing on whether the response to time period differed for hospitals that in the post-PPS period had no psychiatric unit, an exempt psychiatric unit, or a nonexempt unit, and by ward placement within hospitals with psychiatric units. Quality of ca…
Switches Between Prepaid and Fee-For-Service Health Systems Among Depressed Outpatients: Results From the Medical Outcomes Study
We analyzed switches between prepaid and fee-for-service health care plans among depressed outpatients in the longitudinal part of the Medical Outcomes Study. Patients of mental health specialists in fee-for-service plans had the lowest adjusted rate of plan switching (8.1%), compared to fee-for-service general medical patients (13.5%) and prepaid patients of both types of providers (10.1% to 11.7%). Although there were no substantial differences…
The Role of Depression in Hypertension-Related Mortality
Department of Psychiatry Neuropsychiatric Institute University of California, Los Angeles School of Medicine Los Angeles, California
Medicine (80 works) · Psychiatry (55 works) · Mental health (51 works) · Psychology (51 works) · Political science (39 works) · Mental Health Treatment and Access (37 works) · Public relations (28 works) · Sociology (28 works) · Nursing (26 works) · Health care (23 works)