CORE--SERVICE INNOVATIONS

核心——服务创新

• 批准号: 6650638
• 负责人: ELIZABETH A BOYD
• 金额: $ 17.24万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6650638
• 关键词: antipsychotic agents; behavioral /social science research tag; biomedical facility; caregivers; clinical research; clinical trials; cognitive behavior therapy; community mental health services; family structure /dynamics; health care policy; health care service utilization; health services research tag; human subject; human therapy evaluation; interview; managed care; mental disorder chemotherapy; motivation; outcomes research; patient care management; quality of life; relapse /recurrence; schizophrenia; telecommunications; therapy compliance

Description: The Center has embarked on a systematic study of the changing mental health system. This core supports that effort along several dimensions through four projects that focus on the "meso" and direct service level of mental health services delivery. These levels address the implementation of disease management programs, the organization and management of patient care teams, and the rules for triage and eligibility for specialized services. This focus is seen as necessary, according to the researchers, due to the challenge of adapting the results of efficacy studies to real conditions under which mental health services are provided, and to improve the effectiveness of managed care strategies, and incentives. The studies follow a trajectory of methodologies that began with descriptive studies, followed by multivariate prospective studies to more complex randomized controlled trials. The subject of the proposed work is patient compliance, specifically medication compliance in different service settings. They propose to examine strengthening client/family interactions through building bonds of reciprocity; tracking portions of the mental health delivery systems through collaboration on the Health Care for Communities (HCC) survey and through state surveys of residential facilities. For Project 1A (p 306), it is proposed that compliance behavior be controlled for when evaluating experimental-control group differences in clinical and social outcomes at 6 and 12 weeks. It is presumed that compliance here means compliance with the compliance therapy. In any case, the investigators should be more specific about how they propose to adjust for compliance behavior given the pitfalls of adjusting for observed compliance when analyzing differences between randomized groups. Given the investigators? knowledge of instrumental variables, it is likely that they understand the use of this approach to adjust for non-compliance with the compliance therapy. Also for Project 1A (p 306), a cost analyses is proposed without specifics. The analysis plans for Projects 2 and 3 (p. 308-309, 311-312) are too general, especially given that analyses are planned in the first year of the grant (p. 317). The pilot data analysis proposed for Project 4 (page 315-316) appears to run the risk of possible non-compliance problems with the INCube program. An instrumental variable analysis may be appropriate here.

描述：该中心已经开始了对变化的系统研究 心理卫生系统。该核心支持沿几个维度的努力 通过四个专注于“中索”和直接服务水平的项目 心理健康服务交付。这些级别解决了实施 疾病管理计划，患者护理的组织和管理 团队以及分类规则和专业服务的资格。这 根据挑战，研究人员认为，重点被认为是必要的 将功效研究结果适应实际条件的结果 提供心理健康服务，并提高 托管护理策略和激励措施。研究遵循 从描述性研究开始的方法学，然后是多变量 前瞻性研究对更复杂的随机对照试验。主题 拟议的工作是患者合规性，特别是药物合规性 在不同的服务设置中。他们建议检查加强 客户/家庭互动通过建立互惠的纽带；追踪 通过合作 社区医疗保健（HCC）调查以及通过州调查 住宅设施。 对于项目1A（P 306），建议控制合规行为 在评估临床和 6周和12周的社会成果。假定这里的合规性意味着 遵守合规疗法。无论如何，调查人员应该 更具体地说明他们建议如何调整给定的合规行为 分析差异时，调整观察到的合规性的陷阱 在随机组之间。鉴于调查员？具有乐器知识 变量，他们可能了解这种方法的使用来调整 不遵守合规疗法。 同样对于项目1A（第306页），提出了成本分析，而无需具体具体细节。 项目2和3（第308-309、311-312页）的分析计划太一般了， 特别是考虑到分析是在赠款的第一年进行的（p。 317）。 针对项目4（第315-316页）提出的试点数据分析似乎运行 Incube计划可能不遵守问题的风险。一个 仪器变量分析在这里可能是适当的。