John C. Fortney, PhD

Phone: 501.257.1726
E-mail: fortneyjohnc@uams.edu

Medical Sciences
University of Arkansas - Little Rock
4301 W. Markham
Little Rock, AR 72205

Completed Projects (3)

Identifying At-Risk Rural Areas for Targeting Enhanced Depression Treatment, Lead researcher
Research center: WICHE Center for Rural Mental Health Research
Funder: Office of Rural Health Policy (ORHP)
Topic: Mental health
This project will identify characteristics of rural areas that are associated with increased risk of depression-related hospitalizations, and will identify high risk rural areas within the U.S. that should be targeted for early adoption of enhanced depression treatment models based on patient need.

Identifying At-Risk Rural Areas for Targeting Enhanced Schizophrenia Treatment, Lead researcher
Research center: WICHE Center for Rural Mental Health Research
Funder: Office of Rural Health Policy (ORHP)
Topic: Mental health
The goal of this project is to identify rural areas that should be targeted for early adoption of evidence-based schizophrenia treatment. This project proposes a scientifically-based method to identify counties in greatest need for quality improvement to inform national, regional, and local decision-makers about distributing scarce resources to areas which would most benefit from improved schizophrenia treatment.

Rural-Urban Differences In The Use, Type, And Quality Of Depression Treatment, Lead researcher
Research center: WICHE Center for Rural Mental Health Research
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, Health disparities, Mental health, Minority health
As access to evidence-based treatment for affective disorders (major depressive disorder, dysthymia, and bipolar disorder) improves in urban areas, it is critical to monitor rural-urban differences in the use and quality of treatment over time to identify and address rural disparities, especially for vulnerable populations such as the elderly and ethnic minorities.

Publications (15)

Are Primary Care Services a Substitute or Complement for Specialty and Inpatient Services?
Author(s): John C. Fortney, Diane E. Steffick, James F. Burgess Jr., Matt L. Maciejewski, Laura A. Petersen
Research center: WICHE Center for Rural Mental Health Research
Topic: Health services
Citation: Health Services Research, 40(5, Part 1), 1422-42
Date: 2005
Change in distance to primary care was a significant and substantial predictor of change in primary care visits. Analyses indicated that an increase in primary care service use was associated with increases in the use of all specialty outpatient services and inpatient services, as well as increases in inpatient and outpatient costs. Results provide evidence that health systems can implement strategies to encourage their members to use more primary care services without driving up physical health costs.
Assessment of the Mental Health Funding Marketplace in Rural vs. Urban Settings (Working Paper)
Author(s): Jeffrey S. Harman, Fran Dong, Stan Xu, Nathan Ewigman, John C. Fortney
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Date: 02 / 2010
Rural residents are less likely to have mental health services funded through private insurance and more likely through public sources than urban residents, suggesting that targeting policies through public funding sources could be the most effective method to reduce urban-rural disparities in mental health care.
Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings (Summary Brief)
Author(s): Jeffrey S. Harman, John C. Fortney, Fran Dong, Stan Xu
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Data from the National Comorbidity Survey Replication show that rural individuals with mental health problems are significantly less likely to receive mental health services than individuals in urban and suburban areas.
Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings for Individuals with Serious Mental Illness (Findings Brief)
Author(s): Jeffrey S. Harman, John C. Fortney, Fran Dong, Stan Xu
Research center: WICHE Center for Rural Mental Health Research
Topics: Health insurance and the uninsured, Mental health
Date: 03 / 2010
Study was designed to assess the impact of rurality on the source of payment for mental health treatments and determine whether urban-rural differences in source of payment vary for the seriously mentally ill relative to all other mental health conditions.
Association Between Rural Residence and the Use, Type, and Quality of Depression Care (Final Paper)
Author(s): John C. Fortney, Jeffrey S. Harman, Stanley Xu, Fran Dong
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Rural individuals are more reliant on pharmacotherapy than psychotherapy, which may be a concern if this is due to poor access to psychotherapy rather than a preference for antidepressants.
Association Between Rural Residence and the Use, Type, and Quality of Depression Care (Policy Brief)
Author(s): John Fortney, Jeffrey Harman, Stan Xu, Fran Dong
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Date: 05 / 2009
The purpose of the project was to assess the association between rurality and the use, type (pharmacotherapy versus psychotherapy), and quality of care among individuals in the Medical Expenditure Panel Survey with self-reported depression.
Community-Level Risk Factors for Depression Hospitalizations
Author(s): John Fortney, Gerard Rushton, Scott Wood, Lixun Zhang, Kathryn Rost
Research center: WICHE Center for Rural Mental Health Research
Topics: Mental health, Rural statistics and demographics
Report Number: Working Paper
Date: 09 / 2005
Examines the association between depression hospitalization rates and community-level socio-demographic, economic, and health care system characteristics.
Community-Level Risk Factors for Depression Hospitalizations (Fact Sheet)
Author(s): John Fortney, Gerard Rushton, Scott Wood, Lixun Zhang, Stan Xu, Fran Dong, Kathryn Rost
Research center: WICHE Center for Rural Mental Health Research
Topics: Mental health, Rural statistics and demographics
Date: 09 / 2005
Overview of findings from a study to identify community-level risk factors for depression hospitalizations and geographic areas with elevated hospitalization rates.
Differential Effectiveness of Depression Disease Management for Rural and Urban Primary Care Patients
Author(s): Scott J. Adams, Stanley Xu, Fran Dong, John Fortney, Kathryn Rost
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Date: 09 / 2005
Examined whether or not there is a differential impact of enhanced depression care on patient outcomes in rural versus urban primary care settings and whether differences any are mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling). Findings indicate that enhanced care for depression improved mental health status over 18 months for urban primary care populations, but not rural patients. Full report available on request.
Differential Effectiveness of Enhanced Depression Treatment for Rural and Urban Primary Care Patients
Author(s): Scott J. Adams, Stanley Xu, Fran Dong, John Fortney, Kathryn Rost
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Citation: Journal of Rural Health, 22(4), 343-350
Date: 2006
Reports the results of a study that explored whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urban primary care practices and whether the impact is mediated by receiving evidence-based care (antidepressant medication and specialty care counseling). The study found that depression disease management improved the mental health status of urban patients over 18 months but not rural patients. Effects were not mediated by antidepressant medication or specialty care counseling in urban or rural patients.
Does Improving Geographic Access to VA Primary Care Services Impact Patients' Patterns of Utilization and Costs?
Author(s): John C. Fortney, Matt L. Maciejewski, J. Warren, James F. Burgess Jr.
Research center: WICHE Center for Rural Mental Health Research
Topics: Health services, Veterans
Citation: Inquiry, 42(1), 29-42
Date: 2005
The Department of Veterans Affairs (VA) has been establishing community-based outpatient clinics (CBOCs) across the country to improve veterans' access to and use of primary care services, thereby decreasing the need for costly specialty outpatient and inpatient care. Using a quasi-experimental, pre-post study design, the authors examined whether the establishment of CBOCs has affected access, use, and costs for VA patients residing in their catchment areas. Most patients residing in CBOC catchment areas did not receive care at CBOCs, resulting in only small increases in primary care utilization. While CBOCs improved veterans' access, they had little impact on overall patterns of utilization and cost.
One Size Fits Some: the Impact of Patient Treatment Attitudes On the Cost-Effectiveness of a Depression Primary Care Intervention
Author(s): Jeffrey M. Pyne, Kathryn M. Rost, Farah Farahati, Shanti P. Tripathi, Jeffrey Smith, D. Keith Williams, John Fortney, James C. Coyne
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Citation: Psychological Medicine, 35(6), 839-854
Date: 2005
Reports the results of a study that estimated the impact of patient receptivity to antidepressant medication on the cost-effectiveness of an evidence-based primary-care depression intervention.
Role of Social Support and Stressful Life Events in the Effectiveness of Collaborative Care for Depression: A Rural-Urban Comparison
Author(s): K. Albright, John C. Fortney, Scott J. Adams, Stanley Xu, F. Dong
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Date: 2005
Rural-Urban Difference in Health Care Benefits of Community-Based Sample of At-Risk Drinkers
Author(s): John C. Fortney, Brenda M. Booth, JoAnn E. Kirchner, Xiaotong Han
Research center: WICHE Center for Rural Mental Health Research
Topic: Substance abuse
Citation: Journal of Rural Health, 19(3), 292-298
Date: 2003
Compares the cost-containment strategies used by health plans of insured at-risk drinkers residing in rural and urban areas.
Rural-Urban Differences in Depression Care (Working Paper)
Author(s): John C. Fortney, Jeffrey S. Harman, Stanley Xu, Fran Dong
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Date: 10 / 2009
Assesses the association between rurality and depression care. Reports that rural individuals are more reliant on pharmacotherapy than psychotherapy.

Topics Centers Researchers Other Resources Search		John C. Fortney, PhD Phone: 501.257.1726 E-mail: fortneyjohnc@uams.edu Medical Sciences University of Arkansas - Little Rock 4301 W. Markham Little Rock, AR 72205 Completed Projects (3) Identifying At-Risk Rural Areas for Targeting Enhanced Depression Treatment, Lead researcher Research center: WICHE Center for Rural Mental Health Research Funder: Office of Rural Health Policy (ORHP) Topic: Mental health This project will identify characteristics of rural areas that are associated with increased risk of depression-related hospitalizations, and will identify high risk rural areas within the U.S. that should be targeted for early adoption of enhanced depression treatment models based on patient need. Identifying At-Risk Rural Areas for Targeting Enhanced Schizophrenia Treatment, Lead researcher Research center: WICHE Center for Rural Mental Health Research Funder: Office of Rural Health Policy (ORHP) Topic: Mental health The goal of this project is to identify rural areas that should be targeted for early adoption of evidence-based schizophrenia treatment. This project proposes a scientifically-based method to identify counties in greatest need for quality improvement to inform national, regional, and local decision-makers about distributing scarce resources to areas which would most benefit from improved schizophrenia treatment. Rural-Urban Differences In The Use, Type, And Quality Of Depression Treatment, Lead researcher Research center: WICHE Center for Rural Mental Health Research Funder: Office of Rural Health Policy (ORHP) Topics: Aging, Health disparities, Mental health, Minority health As access to evidence-based treatment for affective disorders (major depressive disorder, dysthymia, and bipolar disorder) improves in urban areas, it is critical to monitor rural-urban differences in the use and quality of treatment over time to identify and address rural disparities, especially for vulnerable populations such as the elderly and ethnic minorities. Publications (15) Are Primary Care Services a Substitute or Complement for Specialty and Inpatient Services? Author(s): John C. Fortney, Diane E. Steffick, James F. Burgess Jr., Matt L. Maciejewski, Laura A. Petersen Research center: WICHE Center for Rural Mental Health Research Topic: Health services Citation: Health Services Research, 40(5, Part 1), 1422-42 Date: 2005 Change in distance to primary care was a significant and substantial predictor of change in primary care visits. Analyses indicated that an increase in primary care service use was associated with increases in the use of all specialty outpatient services and inpatient services, as well as increases in inpatient and outpatient costs. Results provide evidence that health systems can implement strategies to encourage their members to use more primary care services without driving up physical health costs. Assessment of the Mental Health Funding Marketplace in Rural vs. Urban Settings (Working Paper) Author(s): Jeffrey S. Harman, Fran Dong, Stan Xu, Nathan Ewigman, John C. Fortney Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Date: 02 / 2010 Rural residents are less likely to have mental health services funded through private insurance and more likely through public sources than urban residents, suggesting that targeting policies through public funding sources could be the most effective method to reduce urban-rural disparities in mental health care. Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings (Summary Brief) Author(s): Jeffrey S. Harman, John C. Fortney, Fran Dong, Stan Xu Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Data from the National Comorbidity Survey Replication show that rural individuals with mental health problems are significantly less likely to receive mental health services than individuals in urban and suburban areas. Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings for Individuals with Serious Mental Illness (Findings Brief) Author(s): Jeffrey S. Harman, John C. Fortney, Fran Dong, Stan Xu Research center: WICHE Center for Rural Mental Health Research Topics: Health insurance and the uninsured, Mental health Date: 03 / 2010 Study was designed to assess the impact of rurality on the source of payment for mental health treatments and determine whether urban-rural differences in source of payment vary for the seriously mentally ill relative to all other mental health conditions. Association Between Rural Residence and the Use, Type, and Quality of Depression Care (Final Paper) Author(s): John C. Fortney, Jeffrey S. Harman, Stanley Xu, Fran Dong Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Rural individuals are more reliant on pharmacotherapy than psychotherapy, which may be a concern if this is due to poor access to psychotherapy rather than a preference for antidepressants. Association Between Rural Residence and the Use, Type, and Quality of Depression Care (Policy Brief) Author(s): John Fortney, Jeffrey Harman, Stan Xu, Fran Dong Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Date: 05 / 2009 The purpose of the project was to assess the association between rurality and the use, type (pharmacotherapy versus psychotherapy), and quality of care among individuals in the Medical Expenditure Panel Survey with self-reported depression. Community-Level Risk Factors for Depression Hospitalizations Author(s): John Fortney, Gerard Rushton, Scott Wood, Lixun Zhang, Kathryn Rost Research center: WICHE Center for Rural Mental Health Research Topics: Mental health, Rural statistics and demographics Report Number: Working Paper Date: 09 / 2005 Examines the association between depression hospitalization rates and community-level socio-demographic, economic, and health care system characteristics. Community-Level Risk Factors for Depression Hospitalizations (Fact Sheet) Author(s): John Fortney, Gerard Rushton, Scott Wood, Lixun Zhang, Stan Xu, Fran Dong, Kathryn Rost Research center: WICHE Center for Rural Mental Health Research Topics: Mental health, Rural statistics and demographics Date: 09 / 2005 Overview of findings from a study to identify community-level risk factors for depression hospitalizations and geographic areas with elevated hospitalization rates. Differential Effectiveness of Depression Disease Management for Rural and Urban Primary Care Patients Author(s): Scott J. Adams, Stanley Xu, Fran Dong, John Fortney, Kathryn Rost Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Date: 09 / 2005 Examined whether or not there is a differential impact of enhanced depression care on patient outcomes in rural versus urban primary care settings and whether differences any are mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling). Findings indicate that enhanced care for depression improved mental health status over 18 months for urban primary care populations, but not rural patients. Full report available on request. Differential Effectiveness of Enhanced Depression Treatment for Rural and Urban Primary Care Patients Author(s): Scott J. Adams, Stanley Xu, Fran Dong, John Fortney, Kathryn Rost Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Citation: Journal of Rural Health, 22(4), 343-350 Date: 2006 Reports the results of a study that explored whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urban primary care practices and whether the impact is mediated by receiving evidence-based care (antidepressant medication and specialty care counseling). The study found that depression disease management improved the mental health status of urban patients over 18 months but not rural patients. Effects were not mediated by antidepressant medication or specialty care counseling in urban or rural patients. Does Improving Geographic Access to VA Primary Care Services Impact Patients' Patterns of Utilization and Costs? Author(s): John C. Fortney, Matt L. Maciejewski, J. Warren, James F. Burgess Jr. Research center: WICHE Center for Rural Mental Health Research Topics: Health services, Veterans Citation: Inquiry, 42(1), 29-42 Date: 2005 The Department of Veterans Affairs (VA) has been establishing community-based outpatient clinics (CBOCs) across the country to improve veterans' access to and use of primary care services, thereby decreasing the need for costly specialty outpatient and inpatient care. Using a quasi-experimental, pre-post study design, the authors examined whether the establishment of CBOCs has affected access, use, and costs for VA patients residing in their catchment areas. Most patients residing in CBOC catchment areas did not receive care at CBOCs, resulting in only small increases in primary care utilization. While CBOCs improved veterans' access, they had little impact on overall patterns of utilization and cost. One Size Fits Some: the Impact of Patient Treatment Attitudes On the Cost-Effectiveness of a Depression Primary Care Intervention Author(s): Jeffrey M. Pyne, Kathryn M. Rost, Farah Farahati, Shanti P. Tripathi, Jeffrey Smith, D. Keith Williams, John Fortney, James C. Coyne Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Citation: Psychological Medicine, 35(6), 839-854 Date: 2005 Reports the results of a study that estimated the impact of patient receptivity to antidepressant medication on the cost-effectiveness of an evidence-based primary-care depression intervention. Role of Social Support and Stressful Life Events in the Effectiveness of Collaborative Care for Depression: A Rural-Urban Comparison Author(s): K. Albright, John C. Fortney, Scott J. Adams, Stanley Xu, F. Dong Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Date: 2005 Rural-Urban Difference in Health Care Benefits of Community-Based Sample of At-Risk Drinkers Author(s): John C. Fortney, Brenda M. Booth, JoAnn E. Kirchner, Xiaotong Han Research center: WICHE Center for Rural Mental Health Research Topic: Substance abuse Citation: Journal of Rural Health, 19(3), 292-298 Date: 2003 Compares the cost-containment strategies used by health plans of insured at-risk drinkers residing in rural and urban areas. Rural-Urban Differences in Depression Care (Working Paper) Author(s): John C. Fortney, Jeffrey S. Harman, Stanley Xu, Fran Dong Research center: WICHE Center for Rural Mental Health Research Topic: Mental health Date: 10 / 2009 Assesses the association between rurality and depression care. Reports that rural individuals are more reliant on pharmacotherapy than psychotherapy.