Accessed September 23, 2022. Accessed September 23, 2022. Accessed September 23, 2022. [mp=title, book title, abstract, original title, name of substance word, subject heading word, floating sub-heading word, keyword heading word, organism supplementary concept word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] Data abstraction forms will be developed after full text review and the data to be included in evidence tables will be discussed with the AHRQ TOO, the TEP, and the partners. 2021 Feb;40(2):297-306. https://doi.org/10.1377%2Fhlthaff.2020.01452. Integrating behavioral health across the continuum of care. Accessed September 23, 2022. Review of Key Questions VIII. New York, NY: The Commonwealth Fund; 2002 Mar. Upstream strategies include to improve community conditions. 2018 Dec 27;10:1-12. https://doi.org/10.2147%2FSAR.S183252. www.hpoe.org/integratingbehavioralhealth. 2018;172(11):1038-1044. https://doi.org/10.1001/jamapediatrics.2018.2537. Accessed September 23, 2022. Civilian Noninstitutionalized Population, 2013 and 2018, Total Expenses, Total Utilization, and Sources of Payment for Outpatient Prescription Opioids in the U.S. 2021 Sep 1;15:100847. https://doi.org/10.1016/j.ssmph.2021.100847. Substance Use Tools & Resources | The Academy Lopez N, Gadsden VL. [mp=title, book title, abstract, original title, name of substance word, subject heading word, floating sub-heading word, keyword heading word, organism supplementary concept word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] [mp=title, book title, abstract, original title, name of substance word, subject heading word, floating sub-heading word, keyword heading word, organism supplementary concept word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] Agency for Healthcare Research and Quality. 2002 Mar;94(3):157-65. https://doi.org/10.1016/j.pec.2004.02.011. Behavioral Health Integration | Improving Primary Care Team Guide The following definition was adopted. Finally, the Academy helps those who are trying to integrate . Translational Issues in Psychological Science. 91. 6 exp obstetrics/ After studies are deemed to meet inclusion criteria, data will be abstracted, including elements such as: study design, year, setting, country, sample size, patient and provider types and characteristics (e.g., age, sex, race, diagnosis/condition, provider training/background/scope of practice), integration approach characteristics, and results relevant to each Question as outlined in the previous PICOS section. https://www.ahrq.gov/research/findings/nhqrdr/nhqdr21/index.html. 2015 Apr;16(4):319-26. https://doi.org/10.1111%2Fobr.12266. 2019 Jun 24;21(6):e13300. Accessed September 23, 2022. HighVery confident that the estimate of effect lies close to the true effect for this outcome. Grant Number Accessed September 23, 2022. Search Strategy. Behavioral Health | Digital Healthcare Research Using integrated behavioral healthcare to address behavioral health disparities in underserved populations. Accessed September 23, 2022. Centers for Disease Control and Prevention. Purpose: This topic brief summarizes information addressing two topic nominations submitted on the AHRQ Effective Health Care Program website on October 4 and October 29, 2021. Integrating Behavioral Health and Primary Care Provider- and Practice-Level Competencies for Integrated Behavioral Health in Primary Care Literature Review Provider- and Practice-Level Competencies for Integrated Behavioral Health in Primary Care Literature Review Prepared for: Agency for Healthcare Research and Quality Rockville, MD www.ahrq.gov A scoping review of associations between cannabis use and anxiety in adolescents and young adults. This webinar, hosted by the SAMHSA-funded GAINS Center for Behavioral Health and Justice Transformation, will introduce the Vocational Work Enclave model and how it can improve and support successful long-term employment for people with criminal justice involvement. How do the barriers, facilitators, and other factors involved in the implementation of behavioral health and primary care interact to affect implementation and sustainability? Part 2: Co-occurring substance use disorder and physical comorbidities. Technical Experts X. 73. Accessed September 23, 2022. 2008 Oct 22;47(4):438-54. https://doi.org/10.1080/00981380802344480. The disposition of comments for systematic reviews and technical briefs will be published 3 months after publication of the evidence report. Behavioral and Mental Health - Agency for Healthcare Research and Quality Does patient educational level affect office visits to family physicians? United States Government Accountability Office. Who can benefit from integrated behavioral health? The purpose of this review is to characterize existing integration approaches, compare their effectiveness (where studies are available), document identified barriers to and facilitators of implementation and maintenance, identify appropriate metrics, and compare care team roles across currently used approaches to integration. 2006 Mar;36(3):353-63. https://doi.org/10.1017/s0033291705006896. Home | Agency for Healthcare Research and Quality 16. 19. Accessed September 23, 2022. A literature review highlighting a comprehensive set of competencies, practices, providers, and staff required to advance integration efforts and provide comprehensive care to improve patient outcomes. Behavioral health problems, which include mental health and substance use disorders, are among the most common conditions seen in primary care settings. 2021;4(3):e213789. 11. This project and report adopt definitions from the AHRQ Lexicon for Behavioral Health and Primary Care Integration.7 These definitions are provided below to ensure consistency across . 19 11 and 18 Fatigue is among the most common symptoms in MS, resulting in reduced mobility and quality of life. Accessed September 23, 2022. Key Question (2) and Sub-question 5a. Engaging patients to improve quality of care: A systematic review. Accessed September 23, 2022. 8 exp geriatrics/ Butler M, Kane RL, McAlpine D, Kathol RG, Fu SS, Hagedorn H, Wilt TJ. Accessed September 23, 2022. Drug Alcohol Depend. Each full-text article will be independently reviewed for eligibility by two team members, including any articles suggested by peer reviewers or that arise from the public posting process. Ensure ready access to assessment and management for patients in crisis. Bombard Y, Baker GR, Orlando E, Fancott C, Bhatia P, Casalino S, Onate K, Denis JL, Pomey MP. We will follow up on the suggestions made by KIs and TEP members and will track publications and organizations cited in included studies and reports. This web page highlights AHRQ's Substance Use Collection and other resources to assist with the prevention and treatment of behavioral health problems in primary care settings, including data to quantify these challenges, tools and resources for screening and treatment, and funding for behavioral health research. Cully JA, Stanley MA, Petersen NJ, Hundt NE, Kauth MR, Naik AD, Sorocco K, Sansgiry S, Zeno D, Kunik ME. Review Questions (Scan, Key, and Contextual), Mental health and COVID-19: early evidence of the pandemics impact [Scientific Brief]. To sign up for updates or to access your subscriberpreferences, please enter your email address below. Ongoing collaboration and coordination of care are required; activities may include screening and diagnosis, acute and long-term interventions, and followup and maintenance. 2018 Jul 26;13(1):98. https://doi.org/10.1186/s13012-018-0784-z. Medicine to explore and articulate recommendations to advance integrated behavioral health and primary care as one strategy to support a culture of health. HHS Roadmap for Behavioral Health Integration | HHS.gov 13. The search strategies were developed by a research librarian with expertise in conducting searches for systematic reviews and reviewed by the TEP. 35. Obes Rev. There are five questions; one designed to characterize the different behavioral health integration approaches that have been or are being used (Scan Question); one which will assess the evidence for the effectiveness of the approaches in improving relevant outcomes (Key Question); and three (Contextual Questions) that address barriers and facilitators to implementation and maintenance, measuring integration, and the make-up and training of clinical teams. 98. Definition of Terms VII. York (UK): Centre for Reviews and Dissemination (UK); 1995. https://www.ncbi.nlm.nih.gov/books/NBK76532/. The Technical Expert Panel is selected to provide broad expertise and perspectives specific to the topic under development. Telephone: (301) 427-1364, The Academy for Integrating Behavioral Health and Primary Care, https://www.ahrq.gov/cpi/about/otherwebsites/integrationacademy.ahrq.gov/index.html, AHRQ Publishing and Communications Guidelines, Evidence-based Practice Center (EPC) Reports, National Healthcare Quality and Disparities Reports, National Healthcare Quality and Disparities Report, Healthcare Cost and Utilization Project (HCUP), AHRQ Quality Indicator Tools for Data Analytics, United States Health Information Knowledgebase (USHIK), AHRQ Informed Consent & Authorization Toolkit for Minimal Risk Research, Grant Application, Review & Award Process, Study Sections for Scientific Peer Review, Getting Recognition for Your AHRQ-Funded Study, AHRQ Research Summit on Diagnostic Safety, AHRQ Research Summit on Learning Health Systems, National Action Alliance To Advance Patient Safety, National Advisory Council for Healthcare Research and Quality, U.S. Department of Health & Human Services. AHRQ has multiple initiatives to implement evidence-based practices in screening and management of unhealthy opioid and alcohol use. 50. https://nccdh.ca/glossary/entry/marginalized-populations. Literature Databases: Ovid MEDLINE, PsycINFO, CINAHL, SocINDEX, and Cochrane CENTRAL will be searched to capture both published and gray literature. 14 exp health behavior/ or exp attitude to health/ Braveman P, Arkin E, Orleans T, Proctor D, Plough A. Striving to provide whole-person care and patient-centered care recognizes behavioral health affects physical health and physical health affects behavioral health. "I am not a junkie": social categorization and differentiation among people who use drugs. Follow guidance on how to integrate behavioral health and medication-assisted treatment for opioid use disorder into primary care or other ambulatory care settings. 2021 Jan-Dec;12:21501327211049053. https://doi.org/10.1177%2F21501327211049053. An official website of the Department of Health and Human Services, Latest available findings on quality of and access to health care. Association of integrated team-based care with health care quality, utilization, and cost. Accessed September 23, 2022. Downstream strategies include providing clinical care. 2018 Jul 1;53:1-1. https://doi.org/10.1016/j.genhosppsych.2018.04.002. We will consider how recent frameworks might be used to help standardize the description of integration strategies identified for this review. Data synthesis will differ across the three categories of questions (Scan, Key, and Contextual). American Hospital Association. Sun M, Oliwa T, Peek ME, Tung EL. Inertial sensor-based gait parameters reflect patient-reported fatigue PDF Ibh Basics Webinar #1 Integrated Behavioral Health: the What and How Learn about the following topic areas as they relate to integrated behavioral health: Integrating Behavioral Health & Primary Care, Integrating Behavioral Health and Primary Care Playbook, Medication-Assisted Treatment for Opioid Use Disorder Playbook, Usefulness of Behavioral Health Apps in Primary Care, EvidenceNOW: Managing Unhealthy Alcohol Use, HHS During topic refinement, Key Informants assisted with generating a list of integration modes and approaches that we will translate into our initial search strategy. Accessed September 23, 2022. What is Integrated Behavioral Health? | The Academy Key Question 2 and Question 5a. 2018 Nov 1;192:316-323. https://doi.org/10.1016%2Fj.drugalcdep.2018.08.013. 2018 Apr 16;65(5):561-78. https://doi.org/10.1080/00918369.2017.1328224. Behavioral Health Using Smart Devices to Implement an Evidence-based eHealth System for Older Adults Description This research aims to develop and test a voice-activated smart system that will promote self-management and provide coping tools, motivation, and social support to help older adults with multiple chronic conditions. As such, we will assess risk of bias for Questions 2 and 5a. Accessed September 23, 2022. Population/community/clinic panel health outcomes: Simulated results or responses to hypothetical scenarios or questions, Abbreviations: BH=behavioral health; EMS=emergency medical services; KQ=key question; PC=primary care. Scan Question. MEPS collects data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for, as well as data on the cost, scope, and breadth of health insurance held by and available to U.S. workers. In 2020, approximately one in five adults in the United States experienced a mental illness and 17 million had a substance use disorder (SUD).2 Prevalence of behavioral health disorders among children and young people is estimated to be between 10% to 20%, but more precise estimates are difficult as few receive care for these illnesses (e.g., only about 20% receive mental health services, and even fewer receive services from a pediatric psychiatrist).3,4 Early evidence suggests the COVID-19 pandemic has fueled an increase in several behavioral health disorders, including anxiety and substance use, in all age groups, with a notable increase among adolescents.5-8 Yet despite the high prevalence of behavioral health disorders in the United States, and their devastating impact, less than half of the 59 million Americans experiencing mental illness in 2020 received any treatment.2 While integration could, and perhaps should occur across all healthcare settings, primary care is where people receive most of their healthcare most of the time.9 Integration of behavioral health and primary care may have the greatest potential to increase access to behavioral healthcare and improve both physical and mental health outcomes for large numbers of people. https://www.commonwealthfund.org/publications/fund-reports/2002/mar/diverse-communities-common-concerns-assessing-health-care. 2017 Jan 1;36(1):124-32. https://doi.org/10.1377/hlthaff.2016.0875. 81. Accessed September 23, 2022. Agency for Healthcare Research and Quality, Rockville, MD. Outcomes of integrated behavioral health with primary care. Cultural Competency New Guides and Other Resources, August Middle Management Academy National Training, 2023 American Psychological Association (APA) Conference, HHS 37. 2015 Jan 1;2:615-21. https://doi.org/10.1016/j.pmedr.2015.07.006. This framework is built on several key components, including documentation of a unified care plan, treatment and referral activities, and supports for patients and families in shared electronic health records (EHRs) and disease registries. https://www.gao.gov/products/gao-19-274. 64. The Milbank Quarterly. It is a core function of the advanced patient-centered medical home.. 30. 86. Washington, DC: The National Academies Press; 2003. https://doi.org/10.17226/12875. Expand All 2012 Aug;169(8):790-804. https://doi.org/10.1176/appi.ajp.2012.11111616. Telephone: (301) 427-1364, What We Know-The Role of Behavioral Health Integration in Reducing Disparities, Ensuring the Advancement of Health Equity within Integrated Care Settings-What Works, Integrating Behavioral Health & Primary Care, Integrating Behavioral Health and Primary Care Playbook, Medication-Assisted Treatment for Opioid Use Disorder Playbook, Usefulness of Behavioral Health Apps in Primary Care, EvidenceNOW: Managing Unhealthy Alcohol Use, Health Equity and Behavioral Health Integration, Integrating behavioral health into primary care, Integrated teams of medical and behavioral health providers, Patients are active participants and partners, create workflows, protocols, and procedures, build partnerships and establish referral processes, https://eohhs.ri.gov/sites/g/files/xkgbur226/files/2021-03/HSTP%20Social%20Determinants%20of%20Health%20Investment%20Strategy_Final.pdf, this toolkit for addressing health equity and racial justice within integrated care settings, a diversity, equity, and inclusion organizational assessment, this toolkit outlines key drivers of racial health equity for review, this framework for belonging, dignity, and justice, this framework for addressing social determinants of health in primary care, these strategies for retaining staff from racial and ethnic minorities groups, these strategies for affirming LGBTQ+ staff, these steps for recruiting a diverse board, this assessment worksheet provides a health equity lens, Avoiding stigmatizing, depersonalizing, and derogatory language and behavior, Communicating internally and externally about equity in health and healthcare, Creating welcoming and safe health spaces, Recognizing and dismantling discrimination and racism, this guide has steps for developing a customized screening program, this guide has strategies for engaging patients about their social risks and needs, this playbook has strategies for fostering community partnerships to address social needs, this guide has steps for selecting a screening a tool, this guide has steps for implementing an ACEs screening program, this guide has strategies for developing a cross-sector trauma-informed network of care for preventing and addressing the impact of ACEs, Telehealth can expand access to integrated behavioral health care, this list of methods for improving access to telehealth, this guide has ideas and questions for addressing health equity in evaluation efforts, health equity, diversity, and inclusion measures, race, ethnicity, language, and other demographic data measures, measures of social conditions, health, community, and well-being, this toolkit has templates, tools, and samples for collecting, managing, and evaluation health equity data, 2021 National Healthcare Quality and Disparities Report, National Healthcare Quality and Disparities Report Chartbooks for Priority Areas and Populations, Disparities in Health and Health Care: 5 Key Questions and Answers, Achieving Racial and Ethnic Equity in U.S. Health Care: Scorecard, The Economic Burden of Mental Health Inequities in the United States Report, Behavioral Health Care in the United States: How It Works and Where It Falls Short, https://www.ahrq.gov/research/findings/nhqrdr/nhqdr21/index.html, https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/discrimination, https://www.rwjf.org/en/library/research/2017/05/what-is-health-equity-.html, https://www.cdc.gov/healthequity/whatis/index.html, https://www.ama-assn.org/delivering-care/health-equity/what-health-equity, https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/, https://nccdh.ca/glossary/entry/marginalized-populations, https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-2-co-occurring-substance-use-disorder-physical-comorbidities, https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health, https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/co-occurring-disorders, https://doi.org/10.1016%2Fj.drugalcdep.2018.08.013, https://doi.org/10.1377/hlthaff.2016.0875, https://www.rand.org/pubs/tools/TL221.html, https://www.ahrq.gov/patient-safety/settings/long-term-care/resource/multichronic/mcc.html, https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/behavioral-health-primary-care-integration, https://doi.org/10.1186%2Fs13012-018-0784-z, https://doi.org/10.1016/j.ssmph.2021.100847, https://www.gao.gov/products/gao-22-104597, https://doi.org/10.1177%2F21501327211049053, https://doi.org/10.1080/00981380802344480, https://doi.org/10.1001/archpsyc.1993.01820140007001, https://bipartisanpolicy.org/download/?file=/wp-content/uploads/2021/03/BPC-MC-FINAL-Slide-deck-on-Mental-Health-Analysis-Poll.pdf, https://www.annfammed.org/content/annalsfm/2/4/305.full.pdf, https://doi.org/10.1017/S1463423618000403, https://www.aha.org/system/files/media/file/2019/05/aha-cs-gbmc-0519.pdf, https://doi.org/10.1016/j.genhosppsych.2008.09.004, https://doi.org/10.1016/j.genhosppsych.2018.04.002, https://doi.org/10.1080%2F13548506.2016.1227855, https://doi.org/10.1097/MD.0000000000027066, https://doi.org/10.1007/s10880-018-9564-9, https://www.aha.org/center/emerging-issues/market-insights/behavioral-health-integration/behavioral-health-integration-treating-whole-person, https://www.aha.org/issue-brief/2019-12-11-integrated-behavioral-health-high-value-care, https://doi.org/10.2337/diacare.29.02.06.dc05-1572, https://doi.org/10.1016/j.amepre.2012.01.011, https://doi.org/10.1016/j.amepre.2012.01.019, https://doi.org/10.1176/appi.ajp.2016.16050507, https://doi.org/10.1002/14651858.CD006525.pub2, https://www.jabfm.org/content/jabfp/30/2/130.full.pdf, https://doi.org/10.1017/s0033291705006896, https://doi.org/10.1176/appi.ajp.2012.11111616, https://doi.org/10.1001/archpsyc.62.12.1332, https://doi.org/10.1001/jamapediatrics.2015.1141, https://doi.org/10.1007/s11606-017-4101-3, https://www.ncbi.nlm.nih.gov/books/NBK76532/, https://doi.org/10.1097/MLR.0000000000000927, https://doi.org/10.1186/s13012-018-0784-z, https://www.ahrq.gov/news/blog/ahrqviews/achieve-health-equity.html, https://doi.org/10.1001/jamanetworkopen.2021.3789, https://doi.org/10.1007/s40596-020-01276-z, https://www.apa.org/workforce/data-tools/demographics, https://www.census.gov/library/stories/2019/08/your-health-care-in-womens-hands.html, https://www.bls.gov/opub/reports/womens-databook/2019/home.htm, https://doi.org/10.1016/j.ijnsa.2022.100066, https://doi.org/10.1080/00918369.2011.614902, https://doi.org/10.1080/00918369.2017.1328224, https://doi.org/10.1001/journalofethics.2016.18.10.fred1-161, https://doi.org/10.1001/jamanetworkopen.2020.29650, https://doi.org/10.1016/j.pmedr.2015.07.006, https://doi.org/10.1080/00918369.2021.1945338, https://www.commonwealthfund.org/publications/fund-reports/2002/mar/diverse-communities-common-concerns-assessing-health-care, https://doi.org/10.1377/hlthaff.2021.01423, https://doi.org/10.1377%2Fhlthaff.2020.01452, https://www.ncbi.nlm.nih.gov/books/NBK44246/, https://doi.org/10.1016/j.pec.2004.02.011, https://www.pewtrusts.org/en/research-and-analysis/articles/2020/03/26/african-americans-often-face-challenges-accessing-substance-use-treatment, https://www.rwjf.org/en/library/research/2019/02/medicaid-s-role-in-addressing-social-determinants-of-health.html, https://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health-rankings-model, https://www.cdc.gov/policy/polaris/healthtopics/ace/index.html, https://www.cdc.gov/violenceprevention/aces/about.html, https://doi.org/10.1001/jamapediatrics.2018.2537, https://doi.org/10.1016/j.nurpra.2020.08.002, https://doi.org/10.1016/j.amepre.2020.01.009, https://bipartisanpolicy.org/report/behavioral-health-2021/, HHS Research Protocol: From our preliminary review of the literature, the majority of the available evidence is unlikely to be large randomized controlled trials (RCTs) with patient-level randomization that assess effectiveness. Key Informants are not involved in analyzing the evidence or writing the report. 2020 Oct;44(5):523-30. https://doi.org/10.1007/s40596-020-01276-z. Chapter 5, When the doctor-patient divide is a chasm. 58. The Annals of Family Medicine. Xylazine use presents many potential dangers to people, including an increased risk of overdose and the development of necrotizing tissue damage. 3. Providers practicing integrated behavioral health care recognize that both medical and behavioral health factors are important parts of a persons overall health. Thapa BB, Laws MB, Galrraga O. About the CDC-Kaiser ACE study. Patients like the convenience of one-stop shopping. Whether their problem is stress, mental health, substance use, health behaviors, or all of the above, there is no wrong door. According to the Agency for Healthcare Research and Quality (AHRQ) Academy (a part of the US Department of Health & Human Services attempting to universalize the language and conception of IBH), the definition of IBH includes a team of primary and mental health clinicians working together with patients and their families. The Pew Charitable Trusts. 18. For Question 4, our working definition for our search for valid and reliable studies will limit inclusion to measures that have been used and evaluated. 9 exp health services for the aged/ Background: Multiple sclerosis (MS) is a disabling disease affecting the central nervous system and consequently the whole body's functional systems resulting in different gait disorders. 1993;50(2):85-94. https://doi.org/10.1001/archpsyc.1993.01820140007001. What Can Primary Care Physicians Do? 2014 Apr;133(4):e981-92. Full text for all abstracts deemed appropriate for consideration by at least one of the reviewers will be retrieved. 11 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 For patients with mental health or substance abuse problems, outcomes are best when primary care and behavioral health integrate their care to: Provide collaborative care in primary care for patients with chronic mental health/substance abuse problems. American Psychological Association. 12 exp behavioral medicine/ or exp Behavior therapy/ The Healthcare Cost and Utilization Project (HCUP) is the Nation's most comprehensive source of hospital care data, including information on in-patient stays, ambulatory surgery and services visits, and emergency department encounters. Behavioral health clinicians often work right in the medical setting, or, if not onsite, are thoroughly integrated into the established procedures, team, and information systems. Accessed September 23, 2022. Families, Systems, & Health. Typically, medical and behavioral health clinicians collaborate with each other and with patients and families to address health concerns identified during medical visits. The Agency for Healthcare Research and Quality (AHRQ) posted the Key Questions on the AHRQ Effective Health Care Website for public comment. Any disagreements will be resolved by consensus among investigators. Improving efficiency and access to mental health care: Combining integrated care and advanced access. Diabetes Care. 62. 21. Rockville, MD 20857 A new topic brief from AHRQ summarizes the evidence on finding, evaluating and selecting smartphone and Internet-based behavioral health apps to recommend or prescribe in primary care and integrated care settings. Integrated teams of medical and behavioral health providers deliver care for medical conditions, including problematic health behaviors, crises in life, mental health disorders, and substance use in primary and ambulatory care settings. https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/. Question 4 (Contextual). 57. Primary Health Care Research & Development. Accessed September 23, 2022. Role of the Funder XIII. Accessed September 23, 2022.
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