A Family Peer Navigator Model to Increase Access and Initial Engagement in Coordinated Specialty Care Programs Among Black Families

家庭同伴导航模型，以增加黑人家庭对协调专业护理计划的访问和初步参与

• 批准号: 10424755
• 负责人: Oladunni Oluwoye
• 金额: $ 15.3万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10424755
• 关键词: 20 year old; Address; Administrator; African American; African American population; Area; Black Populations; Black race; Caring; Clinical; Communities; Coordinated Specialty Care; Data; Development; Diagnosis; Discrimination; Effectiveness; Enrollment; Evidence based treatment; Family; Family member; Feedback; Formulation; Goals; Health; Health Personnel; Health Services Research; Improve Access; Individual; Intake; Intensive Care; Intervention; Intervention Studies; Interview; Knowledge; Mental Health; Mental Health Services; Methods; Modeling; National Institute of Mental Health; Outcome; Pathway interactions; Persons; Phase; Play; Population Heterogeneity; Process; Provider; Psychoses; Public Health; Quality of life; Randomized; Reporting; Research; Research Support; Role; Sampling; Schizophrenia; Self Efficacy; Services; Telephone; Time; Training; Washington; Youth; active control; base; care coordination; care providers; design; disparity reduction; duration of untreated psychosis; early psychosis; effectiveness implementation study; ethnic minority; evidence base; experience; first episode psychosis; functional outcomes; health service use; implementation outcomes; implementation process; implementation strategy; improved; informant; innovation; loved ones; model design; peer; pilot test; pilot trial; programs; psychiatric symptom; psychoeducation; psychosis risk; racial and ethnic; racial and ethnic disparities; racial disparity; randomized trial; recruit; service engagement; social; telephone-based; theories; treatment comparison

ABSTRACT Family members have a key role in facilitating the initiation of mental health services. Yet, Black/African American families often encounter barriers and experience delays accessing coordinated specialty care programs. These delays can be attributed to individual (e.g., knowledge), interpersonal (e.g., connectedness), community (e.g., access), and societal (e.g., discrimination) factors. In other health related areas, peer navigator models improve access to much needed services and promote more positive experiences among individuals and their families. However, there are have been no family peer navigator models developed to address the complexities that impact Black/African American families to improve access to coordinated specialty care programs. Preliminary research suggests approximately 70% of Black/African American family members report no contact with clinicians prior to initial diagnosis and the receipt of services for early psychosis. Among Black/African Americans, family member engagement prior to services and during treatment for first episode psychosis significantly impacts clinical and functional outcomes among youth enrolled in coordinated specialty care programs. Building upon formative research, this mixed methods study will be conducted in three phases to develop, refine, and pilot-test a multi-component Family Peer Navigator model designed to increase access and engagement in coordinated specialty care programs Black families. A community advisory board will provide feedback during each Phase II and III to refine the navigator model. The Family Peer Navigator model will utilize telephone-based strategies and encompass the Cultural Formulation Interview to tailor family psychoeducation and care coordination. Phase I and Phase II utilize an exploratory-sequential mixed methods design to refine the Family Peer Navigator model and implementation strategy. Phase I involves qualitative interviews with coordinated specialty care directors and providers, and agency-level administrators. Phase II is a 4-month open trial that will recruit up to 10 Black families. Phase III will consist of an embedded mixed methods designed randomized pilot trial of the Family Peer Navigator model against a low-intensive care coordination in two coordinated specialty care programs. The acceptability, feasibility, and preliminary impact will be assessed in a sample of 40 Black/African American families with a loved one at risk for psychosis or currently experiencing their first episode of psychosis. Other outcomes include proposed treatment targets (self-efficacy, knowledge, social connectedness), preliminary impact outcomes (time to coordinated specialty care programs, initial family engagement), and implementation outcomes (acceptability, feasibility, appropriateness). This study will establish an innovative culturally informed family peer navigator model and generate preliminary data to support a Type II hybrid effectiveness-implementation R01 application.

抽象的 家庭成员在促进心理健康服务的启动方面发挥着关键作用。然而，黑人/非洲人 美国家庭在获得协调的专业护理方面经常遇到障碍和延迟 程序。这些延迟可归因于个人（例如知识）、人际交往（例如 连通性）、社区（例如，访问）和社会（例如，歧视）因素。在其他与健康相关的 领域，同行导航模型改善了获得急需服务的机会并促进更积极的 个人及其家庭之间的经历。然而，一直没有家庭同行导航器 为解决影响黑人/非裔美国家庭改善入学机会的复杂性而开发的模型 协调专业护理计划。初步研究表明大约 70% 的黑人/非洲人 美国家庭成员报告在初步诊断和接受服务之前没有与临床医生接触 用于早期精神病。在黑人/非裔美国人中，家庭成员在服务前和服务期间的参与度 首发精神病的治疗显着影响青少年的临床和功能结果 参加协调的专业护理计划。这项混合方法研究以形成性研究为基础 将分三个阶段进行，以开发、完善和试点测试多组件 Family Peer Navigator 旨在增加黑人家庭协调专业护理计划的获取和参与的模型。 社区咨询委员会将在第二阶段和第三阶段提供反馈，以完善导航器模型。 家庭同伴导航器模型将利用基于电话的策略并涵盖文化 制定访谈以定制家庭心理教育和护理协调。第一阶段和第二阶段利用 探索性顺序混合方法设计以完善 Family Peer Navigator 模型和实现 战略。第一阶段涉及与协调的专业护理主管和提供者进行定性访谈，以及 机构级管理员。第二阶段是为期 4 个月的公开试验，将招募最多 10 个黑人家庭。阶段 III 将包括嵌入式混合方法设计的 Family Peer Navigator 随机试点试验 针对两个协调的专业护理计划中的低重症护理协调的模型。这 可接受性、可行性和初步影响将以 40 名黑人/非裔美国人为样本进行评估 有亲人有患精神病风险或目前正在经历首次精神病发作的家庭。其他 结果包括拟议的治疗目标（自我效能、知识、社会联系）、初步 影响结果（协调专业护理计划的时间、最初的家庭参与），以及 实施结果（可接受性、可行性、适当性）。这项研究将建立一个创新的 具有文化背景的家庭同伴导航模型并生成初步数据以支持 II 型混合 有效性-实施 R01 应用程序。