Reducing the Duration of Untreated Psychosis through Community Education

通过社区教育缩短未经治疗的精神病的持续时间

• 批准号: 8895734
• 负责人: STEVEN R LOPEZ
• 金额: $ 18.39万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-26 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8895734
• 关键词: Adolescent; Adult; Age; Age-Years; Attention; Caregivers; Caring; Clinic; Clinical; Communication; Communities; Community Health Education; County; Development; Devices; Early Intervention; Early treatment; Effectiveness; Ensure; Family Caregiver; Generations; Household; Human Resources; Immigrant; Incidence; Individual; Inpatients; Institution; Intake; Language; Latino; Lead; Los Angeles; Maintenance; Mental Health; Mental Health Services; Mexican; Outcome; Patients; Penetration; Persons; Psychotic Disorders; Research; Resources; Risk; Schizophrenia; Services; Source; Surveys; Sustainable Development; Symptoms; Target Populations; Time; Training; acronyms; base; density; disability burden; efficacy evaluation; evidence base; first episode psychosis; high risk; improved; literacy; loved ones; programs; public health relevance; severe mental illness; social; treatment response

DESCRIPTION (provided by applicant): Most informational campaigns to reduce the duration of untreated psychosis (DUP) have been unsuccessful. Moreover, there has been little attention given to high-risk, culturally diverse groups. The overall objective of this application is to strengthen the effectiveness of informational campaigns by bringing more scientific rigor to their development and by extending their reach through sustainable campaigns for diverse, high-risk communities. Spanish-speaking adolescents and adults (ages 15-64) residing in a high density (>80%) Latino (largely Mexican origin) community within Los Angeles County will serve as the target group. This group is at high risk for DUP given its low rates of mental health service use and its large proportion of immigrants because immigrants have elevated incidence rates of psychotic disorders. To achieve the overall objective, a multi-level and multi-platform Spanish language Communication Campaign (CC) will be carried out (a) to increase the psychosis literacy of Spanish-speaking adolescents and adults; (b) to reduce the DUP for Latinos with first-episode psychosis (FEP), and (c) to explore the relationship between DUP and the psychosis literacy of individuals with FEP and their caregivers. Embedded in the multiple media formats is the central message: "Use La CLAve (the clue) to detect serious mental illness in your loved ones", a message that has been shown in preliminary studies to increase psychosis literacy. La CLAve is both an acronym and mnemonic device to help people remember the key symptoms of psychosis. To enhance the sustainability of the CC, multiple levels of the community (individuals, care facilitators, community resources, and the mental health institution) will be administered the program, master copies of the informational campaign will be distributed to key community personnel, and community personnel will be trained to administer key aspects of the CC. To assess the penetration and sustainability of the IC, surveys will be conducted of representative households (N = 500 for each wave) at three time points: baseline, 18 months and 36 months. An increase and maintenance of psychosis literacy is expected over the 3-year period. To assess whether there is a reduction of DUP, intake workers at San Fernando Mental Health Clinic will identify the DUP for all incoming Latino patients with FEP over a 4-year period. Based on incidence rates of psychotic disorders and the population of the targeted community, 60 Latino patients with FEP are expected each year (N = 240). Compared to a 1-year baseline, the DUP is expected to decrease significantly over the next 3 years. To explore the relationship of individual's DUP and psychosis literacy, the psychosis literacy and referral sources of all new FEP patients and their caregivers will be among the relevant variables that are examined. The proposed research program has the potential to lead a second generation of DUP reduction programs, one that has a strong evidence base and that reaches many in need, including those underserved groups with high risk for prolonged DUP.

描述（由申请人提供）：减少未经治疗的精神病（DUP）持续时间的大多数信息活动都没有成功。此外，对高风险，文化多样的群体的关注很少。该应用程序的总体目的是通过将更加科学的严格性发展和通过可持续发展的高风险社区扩展到其覆盖范围来增强信息运动的有效性。讲西班牙语的青少年和成年人（15-64岁）居住在洛杉矶县的高密度（> 80％）拉丁裔（大部分墨西哥起源）社区将作为目标群体。鉴于其精神卫生服务的使用率较低，并且由于移民的发病率升高，因此DUP的风险很高。为了实现总体目标，将进行多层次和多平台的西班牙语传播运动（CC）（a），以提高讲西班牙语的青少年和成人的精神病素养； （b）减少带有第一集精神病（FEP）的拉丁美洲人的DUP，以及（c）探索DUP与患有FEP及其护理人员的人的精神病素养之间的关系。嵌入多种媒体格式的是中心信息：“使用La Clave（线索）检测亲人中的严重精神疾病”，这一信息已在初步研究中显示，以提高精神病素养。 La Clave既是首字母缩写词，也是助记符设备，可帮助人们记住精神病的关键症状。为了提高CC的可持续性，将对社区的多个层次（个人，护理促进者，社区资源和精神卫生机构）进行管理，该计划将分配给关键社区人员，并将对社区人员进行培训，以管理CC的关键方面。为了评估IC的渗透率和可持续性，将在三个时间点（基线，18个月零36个月）对代表家庭进行调查（每个波的n = 500）。预计将在三年内提高和维持精神病素养。为了评估DUP是否减少，San Fernando心理健康诊所的摄入工人将在4年内为所有患有FEP的所有即将到来的Latino患者确定DUP。 根据精神疾病的发病率和目标社区的人口，预计每年有60名Latino FEP患者（n = 240）。与1年的基线相比，预计DUP在未来3年内将显着减少。为了探索个人的DUP和精神病素养的关系，所有新FEP患者及其护理人员的精神素养和推荐来源将成为所检查的相关变量之一。拟议的研究计划有潜力领导第二代DUP减少计划，该计划具有强大的证据基础，并覆盖了许多有需要的人，包括那些服务不足的群体，其长期DUP的风险很高。