Adapting and Testing A Mental Health Services Engagement Program for Racial and Ethnic Minority Young Adults

调整和测试针对少数族裔年轻人的心理健康服务参与计划

• 批准号: 10643265
• 负责人: Kiara Moore
• 金额: $ 19.38万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10643265
• 关键词: Address; Adolescent and Young Adult; Adult; Area; Award; Behavioral; Belief; Clinical; Clinical Trials; Collaborations; Complex; Data; Decision Making; Development; Discrimination; Economics; Educational Curriculum; Ensure; Ethnic Population; Evidence based intervention; Evidence based treatment; Experimental Designs; Feeling; Formulation; Funding; Goals; Grant; Health Disparities Research; Health Personnel; Health Services Research; Healthcare; Imprisonment; Inequity; Intake; Intervention; Interview; K-Series Research Career Programs; Knowledge; Lead; Letters; Mental Health; Mental Health Services; Mental disorders; Mentors; Methods; Minority Groups; Modification; National Institute of Mental Health; New York City; Not Hispanic or Latino; Participant; Persons; Population; Population Heterogeneity; Poverty; Preparation; Process; Provider; Public Health; Recovery; Reporting; Research; Research Activity; Research Personnel; Risk; Sampling; Self Efficacy; Services; Testing; Training; Trust; Uncertainty; Underserved Population; Work; Writing; Youth; aged; brief intervention; care systems; career; design; disparity reduction; distrust; emerging adult; ethnic minority; evidence base; experience; experimental study; feasibility trial; health communication; health determinants; health disparity; health service use; high risk; improved; minority children; mortality; multi-component intervention; multiphase optimization strategy; novel; patient oriented research; peer; person centered; personal narratives; personalized approach; pilot test; post intervention; preference; premature; programs; psychiatric rehabilitation; racial minority; racial population; role model; service engagement; service utilization; severe mental illness; skills; social stigma; socioeconomic disadvantage; structural determinants; therapy development; treatment disparity; young adult

PROJECT SUMMARY/ABSTRACT With rates of mental health service utilization as low as 40%, racial and ethnic minority young adults with serious mental illnesses (SMI) are at high risk for disengaging from mental health services. They experience greater unmet need and increased risk for long-term health disparities, poverty, incarceration, and early mortality. Disparities in treatment engagement are often driven by the lack of services that take into account the unique developmental needs and relevant cultural factors that impact young adults’ on-going participation in treatment. The PI’s preliminary findings among racial and ethnic minority young adults indicate that they desired greater knowledge, appreciation, and support of their cultural identities from mental health providers. However, there are few evidence-based treatment engagement programs for young adults with SMI, and none that explicitly target both the developmental and cultural preferences of those who are racial and ethnic minorities. This Career Development Award proposes a comprehensive path towards becoming an independent clinician investigator adapting and optimizing evidence-based interventions to target cultural determinants of health and reduce mental health disparities among adolescents and young adults. This proposal uses the participatory ADAPT-IT framework to partner with racial and ethnic minority young adults with SMI (n=15), providers (n=9), and expert mentors to adapt a brief, evidence-based young adult treatment engagement intervention to include three new person-centered, cultural identity-focused components. The adapted intervention will then be evaluated in a mixed-methods pilot optimization trial for feasibility, acceptability, and preliminary impact on treatment engagement at an urban, publicly-funded, adult psychiatric rehabilitation program. The pilot comprises the preparation stage of the multiphase optimization strategy (MOST), during which young adults (n=80) will be assigned to one of eight conditions to test new components in an efficient factorial experiment. In-depth interviews administered post-intervention will contextualize and clarify findings. To further her long-term career goal of becoming an independent clinician investigator focused on improving mental health services for underserved youth during the transition to adulthood, the PI will pursue training in the following four areas: (1) developing empirically-driven engagement interventions for older adolescents and young adults, (2) adapting interventions to be culturally relevant to underserved, minoritized populations, (3) using MOST, and (4) grant writing. The product of this study will be an R01 of a large-scale optimization trial powered to test intervention components for efficacy and change in targeted mechanisms of treatment engagement. Overall, this award will ensure the PI’s successful transition to an independent investigator with an established program of research focused on intervention development, adaptation, and optimization for addressing mental health disparities in minoritized adolescents and young adults.

项目摘要/摘要 较低的心理健康服务利用率低至40％，种族和少数民族年轻人 严重的精神疾病（SMI）有脱离精神卫生服务的高风险。他们经历 长期健康分配，贫困，增加和早期的更大未满足需求和增加的风险 死亡。治疗参与方面的差异通常是由于缺乏服务所考虑的 影响年轻人持续参与的独特发展需求和相关文化因素 在治疗中。 PI在种族和少数民族年轻人中的初步发现表明他们 希望从心理健康提供者那里获得更多的知识，欣赏和支持。 但是，对于患有SMI的年轻人，很少有循证治疗参与计划，没有 这明确针对种族和种族的人的发展和文化偏好 少数民族。该职业发展奖提议成为成为一个综合途径 独立的临床研究者适应和优化基于证据的干预措施以靶向文化 健康的决定因素并减少青少年和年轻人的心理健康差异。这个建议 使用参与适应框架与SMI与种族和少数民族年轻人合作 （n = 15），提供者（n = 9）和专家导师，以适应简短的，基于证据的年轻人治疗 参与干预措施包括三个以新的以文化身份为中心的新的，以文化身份为中心的组成部分。这 然后，将在混合方法试验试验中评估改编的干预措施，以实现可行性， 可接受性，并对城市，公共资助的成人精神病学的治疗参与的初步影响 康复计划。飞行员包括多相优化策略的制备阶段 （大多数），在此期间，年轻人（n = 80）将被分配给八个条件之一，以测试新组件 在有效的阶乘实验中。干预后进行的深入访谈将与 澄清发现。为了促进她成为一名专注于独立临床研究者的长期职业目标 在过渡到成年期间，改善服务欠佳的青年的心理健康服务，PI将购买 在以下四个领域中的培训：（1）为老年人开发经验驱动的参与干预措施 青少年和年轻人，（2）调整干预措施在文化上与服务不足，少数化有关 种群，（3）使用大多数，（4）授予写作。这项研究的产物将是大规模的R01 优化试验，用于测试干预组件的效率和目标机制的变化 治疗参与。总体而言，该奖项将确保PI成功过渡到独立 既定研究计划的研究人员都集中于干预开发，适应和 针对少数青少年和年轻人的心理健康差异的优化。