Pathways to Reducing Disparities in Depression Outcomes

减少抑郁症结果差异的途径

基本信息

批准号：
9246994
负责人：
JEANNE MIRANDA
金额：
$ 41.62万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-10 至 2019-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9246994
关键词：
Action Research Address Administrator Affect African American Awareness Caring Case Study Chronic Client Collection Color Communities Community Networks Community Services Comorbidity County Data Data Collection Depressed mood Discrimination Enrollment Evidence based intervention Exercise Family Gender Generations Hair Health Health Care Costs Health Services Accessibility Healthcare Homelessness Housing Income Individual Insurance Intervention Interview Latino Leadership Length of Stay Light Location Los Angeles Mediator of activation protein Medical Mental Depression Mental Health Methods Minority Groups Modeling National Institute of Mental Health Neighborhoods Outcome Outpatients Pathway interactions Patient Self-Report Phase Physical activity Policies Policy Developments Prevalence Primary Health Care Probability Process Provider Psyche structure Public Health Quality of life Randomized Recreation Recruitment Activity Research Research Infrastructure Research Personnel Resources Risk Factors Science Self-Examination Services Social Justice Social Work Subgroup Substance abuse problem Surveys Time Training Trust Uninsured Visit Woman Work base behavioral health collaborative care comparative effectiveness compare effectiveness cost design disparity reduction effectiveness trial ethnic difference ethnic minority population evidence base follow-up health disparity health equity improved intervention effect medical specialties member men metropolitan outreach parent grant physical conditioning programs public health relevance racial difference racism randomized trial screening secondary analysis social social disparities

项目摘要

DESCRIPTION (provided by applicant): Depression for ethnic minorities is a common, disabling condition with documented disparities in access, quality and outcomes of care, particularly in primary care, which is a main treatment setting for ethnic minority groups. Quality improvement programs in primary care can reduce disparities in depression outcomes but are seldom available in vulnerable communities. The proposed project will use the data, partnership infrastructure, and research approach of "Community Partners in Care" (CPIC)-augmented by new collection of qualitative data-to shed light on the pathways by which health and social disparities can be reduced, as well as to illuminate how scientific research can inform policy development for neighborhood-focused health improvement. CPIC is a community-partnered randomized trial comparing the effectiveness of a community engagement and planning (CEP) intervention that activates multi-agency networks versus a technical assistance model for individual agencies, in implementing evidence-based interventions for depression in two under-resourced communities of color in Los Angeles. Analyses of 6-month client outcomes indicate that the CEP intervention, relative to technical assistance, led to improved mental wellness and physical health and reduced prevalence of poor mental health, risk factors for homelessness, and missed work days due to health. CPIC was implemented with community participatory co-leadership, including leaders' self-reflection on racism and social justice. The proposed investigators are original developers of CPIC. The proposed new secondary analyses and new qualitative data collection will clarify pathways for intervention effects on key subgroups (each community, African Americans and Latinos, men and women, homeless); develop explanatory models using mixed-methods; document intervention implementation for these groups; and explore the applicability and generalizability of the CPIC approach for a new Los Angeles County neighborhood-based health improvement initiative. The public health significance of the research is enhanced by the fact that it will be conducted entirely in partnership with leaders and members from the affected communities using a Community Partnered Participatory Research approach, which promotes equality and collaborative responsibility for all phases of work. Through that model's focus on equity and self-reflection among all leaders on the impact of racism, the proposed project will serve as an early example of a fourth-generation approach to addressing health disparities, which combines comprehensive intervention models and research strategy that incorporates the community context for racial and ethnic differences and the interactions in partnered leadership. .

描述（由申请人提供）：少数民族的抑郁症是一种常见的残疾状况，有记录的访问，质量和护理结果差异，尤其是在初级保健中，这是少数民族群体的主要治疗环境。质量初级保健的改进计划可以减少抑郁症结果的差异，但在脆弱的社区中很少有。拟议的项目将使用数据，伙伴关系基础架构以及“护理社区合作伙伴”（CPIC）的研究方法，该方法通过新的定性数据与划分的新收集介绍了可以减少健康和社会障碍的途径，并阐明科学研究如何为社区健康改善的政策开发提供依据。 CPIC是一项社区合作的随机试验，比较了社区参与和计划（CEP）干预的有效性，该试验激活多机构网络与单个机构的技术援助模型，以实施洛杉矶两个资源不足的有色人种社区的基于证据的抑郁症干预措施。对6个月客户结果的分析表明，相对于技术援助，CEP干预导致心理健康和身体健康的改善，心理健康不良，无家可归的危险因素以及由于健康而错过工作日的患病率降低。 CPIC由社区参与性共同领导实施，包括领导人对种族主义和社会正义的自我反思。拟议的调查人员是CPIC的原始开发商。拟议的新二次分析和新的定性数据收集将阐明对关键亚组（每个社区，非裔美国人和拉丁美洲人，男人和女人，无家可归）的干预影响的途径；使用混合方法开发解释模型；这些小组的文档干预实施；并探索CPIC方法在基于洛杉矶县的新邻里健康改善计划中的适用性和概括性。这项研究的公共卫生意义将增强，这将与领导者合作进行，并受影响社区的成员使用社区合作的参与研究方法，该方法促进了所有工作阶段的平等和协作责任。通过该模型对所有领导人对种族主义影响的平等和自我反思的关注，该项目将作为解决健康差异的第四代方法的早期示例，该方法结合了全面的干预模型和研究策略，结合了社区环境的种族和族裔差异以及合作领导的互动。。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Using Stakeholder Input to Inform an Innovative Research and Policy Initiative to Improve Depression in Safety Net Communities.

利用利益相关者的意见为创新研究和政策举措提供信息，以改善安全网社区的抑郁症。

DOI：
10.1353/cpr.2017.0012
发表时间：
2017
期刊：
Progress in community health partnerships : research, education, and action
影响因子：
0
作者：
Khodyakov,Dmitry;Williams,Pluscedia;Bromley,Elizabeth;Chung,Bowen;Wells,Kenneth
通讯作者：
Wells,Kenneth

Community Resilience Learning Collaborative and Research Network (C-LEARN): Study Protocol with Participatory Planning for a Randomized, Comparative Effectiveness Trial.

社区复原力学习协作和研究网络 (C-LEARN)：随机、比较有效性试验的参与式规划研究方案。

DOI：
10.3390/ijerph15081683
发表时间：
2018
期刊：
International journal of environmental research and public health
影响因子：
0
作者：
Springgate,BenjaminF;Arevian,ArmenC;Wennerstrom,Ashley;Johnson,ArthurJ;Eisenman,DavidP;Sugarman,OliviaK;Haywood,CatherineG;Trapido,EdwardJ;Sherbourne,CathyD;Everett,Ashley;McCreary,Michael;Meyers,Diana;Kataoka,Sheryl;Tang
通讯作者：
Tang

Editorial: Developments in Community Partnered Participatory Research for Behavioral Health.

社论：社区合作参与行为健康研究的发展。