Geographic Disparities in the Availability and Accessibility of Coordinated Specialty Care Programs for Early Psychosis

早期精神病协调专业护理计划的可用性和可及性的地理差异

• 批准号: 10523009
• 负责人: Oladunni Oluwoye
• 金额: $ 24.41万
• 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: 2022-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10523009
• 关键词: 20 year old; Address; Administrator; Age; Area; Caring; Censuses; Characteristics; Client; Communities; Coordinated Specialty Care; Data; Data Set; Databases; Decision Aid; Development; Disadvantaged; Early Intervention; Effectiveness; Environment; Ethnic Origin; Family; Focus Groups; Funding; Gender; Geographic Distribution; Geographic Locations; Geography; Goals; Grant; Health; Health Services Accessibility; Incidence; Individual; Internet; Link; Location; Measures; Mental Health; Mental Health Services; National Institute of Mental Health; Neighborhoods; Outcome; Pathway interactions; Persons; Policies; Provider; Psychoses; Public Health; Quality of life; Race; Recovery; Research; Research Support; Resources; Role; Rural; Schizophrenia; Services; Spatial Distribution; Structure; Techniques; Technology; Time; Transportation; Underserved Population; Urbanization; Variant; Visualization; Washington; Work; Youth; base; built environment; care systems; dashboard; density; deprivation; disparity reduction; duration of untreated psychosis; early onset; early psychosis; ethnic diversity; evidence base; experience; first episode psychosis; future implementation; geographic disparity; health disparity populations; improved; inequitable distribution; medical specialties; novel; payment; programs; psychiatric symptom; racial and ethnic; racial disparity; racial diversity; residential segregation; rurality; service gap; service intervention; service utilization; sex; social culture; social determinants; social disparities; socioeconomic disparity; socioeconomics; standard of care; tool; urban area

ABSTRACT Coordinated specialty care (CSC) is the standard of care for early psychosis in the US. Supported by the 5- 10% set-aside in the Community Mental Health Block Grant program, targeted at evidence-based early interventions, approximately 350 CSC programs have been implemented in 49 states across the US. Neighborhoods where individuals reside are important determinants of health and the majority of the extant work on neighborhood-level determinants and early psychosis has focused on the impact on individual-level factors such as the incidence and onset of psychosis, and duration of untreated psychosis, but very few studies have examined neighborhood-level characteristics as barrier to seeking services for early psychosis. Research has highlighted the importance of mental health services being available in proximity to an individual’s community, yet very little is known about the spatial distribution and accessibility of CSC programs in the US. There is a clear gap in what we know about the potential difficulties accessing CSC programs and whether the geographical placement and distribution of CSC programs contributes to inequities. To address this gap, our overarching goal of the proposed study is to characterize CSC programs and understand the geographical distribution and inequities in access to CSC programs. We will create a novel integrative multi-level geospatial database of CSC programs implemented throughout the US, that will include client-level data (race, ethnicity, age, gender), program-level data (geocoded location, capacity, size, setting, payment, role availability), provider-level data (race, ethnicity, professional credentials), and neighborhood-level census data (residential segregation, ethnic density, area deprivation, rural-urban continua, broadband internet subscription, public transit time). Our specific aims are to 1) Characterize the variations in facility-level characteristics of CSC programs by geographical location; 2) Examine geographic availability and accessibility of CSC programs based on neighborhood-level characteristics; and 3) Develop an interactive dashboard, using web-mapping technology, that will enable decision makers and community stakeholders to identify areas with poor access to CSC programs. The proposed research represents a novel application of advanced spatial analytics that will advance understanding on geographic inequities and accessibility of CSC programs, which can used to inform policy and the future implementation of CSC programs in high-need areas with limited access.

抽象的 协调的专业护理（CSC）是美国早期精神病的护理标准。由5-支持 在社区心理健康方面的赠款计划中，有10％的定位，针对以证据的早期为目标 干预措施，大约350个CSC计划已在美国的49个州实施。 个人居住的社区是健康的重要决定者和大多数广泛的社区 在邻里级别的决定者和早期精神病方面的工作集中在对个人级别的影响上 诸如精神病的事件和发作以及未经治疗的精神病的持续时间等因素，但很少 研究已经检查了邻里级别的特征，以寻求早期精神病服务的障碍。 研究强调了精神卫生服务的重要性 对于个人的社区而言，对CSC的空间分布和可访问性知之甚少 在美国的程序。我们对访问CSC的潜在困难有明显的差距 计划以及CSC计划的地理位置和分布是否有助于 不平等。为了解决这一差距，我们提出的研究的总体目标是表征CSC计划 并了解访问CSC计划的地理分布和不平等。我们将创建 一个新颖的集成的CSC计划的多层地理空间数据库，该数据库在美国实施， 将包括客户级数据（种族，种族，年龄，性别），程序级数据（地理编码的位置，容量， 大小，设置，付款，角色可用性），提供商级别的数据（种族，种族，专业证书）和 邻里级人口普查数据（住宅隔离，种族密度，地区剥夺，农村城市 Continua，宽带互联网订阅，公共交通时间）。我们的具体目的是1）表征 通过地理位置，CSC计划的设施级特征的变化； 2）检查地理 基于社区级特征的CSC计划的可用性和可访问性； 3）发展 使用网络映射技术的交互式仪表板将使决策者和社区能够 利益相关者确定访问CSC计划不佳的领域。拟议的研究代表了一个小说 高级空间分析的应用，这些空间分析将提高对地理不平等和 CSC计划的可访问性，可以用来告知政策和CSC的未来实施 访问有限的高需求区域的计划。