Abriendo Caminos: Engaging Latinx Communities Through Culturally Responsive Peer Delivered Motivational Interviewing

阿布里恩多·卡米诺斯（Abriendo Caminos）：通过文化敏感的同伴进行励志访谈来吸引拉丁裔社区

• 批准号: 10664589
• 负责人: Oscar Fernando Rojas Perez
• 金额: $ 16.75万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-17 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10664589
• 关键词: Address; Adult; Age; Alcohol consumption; Attention; Attitude; Caring; Chronic Disease; Clinical; Communities; Contraceptive Agents; Disinfection; Effectiveness; Effectiveness of Interventions; Environment; Ethnic Origin; Ethnic Population; Foundations; Future; General Population; Glean; Goals; Health Personnel; Health system; Individual; Insurance; Intervention; Interview; K-Series Research Career Programs; Latinx; Link; Los Angeles; Measles Vaccine; Mediating; Medicaid; Mental Health; Mental disorders; Mentors; Methods; Mexican; Mexico; Mood Disorders; Morbidity - disease rate; National Institute of Mental Health; Neighborhoods; Outcome; Persons; Pilot Projects; Population; Positioning Attribute; Premature Mortality; Prevention; Provider; Public Health; Quality of life; Race; Recovery; Research; Research Personnel; Research Support; Self-Injurious Behavior; Services; Severity of illness; Strategic Planning; Suicide; Suicide attempt; Thinking; Training; Trauma; Treatment Efficacy; Universities; barrier to care; behavior change; behavior prediction; bilingualism; care delivery; career development; cultural values; design; effectiveness testing; empowerment; evidence base; experience; health inequalities; implementation fidelity; implementation intervention; improved; lens; maltreatment; medical specialties; medication compliance; motivational enhancement therapy; peer; person centered; phenomenological models; physical conditioning; programs; psychotic; racial population; satisfaction; service delivery; service engagement; severe mental illness; social; social factors; treatment adherence; treatment center

Program Summary/Abstract People with serious mental illness (SMI; psychotic and major affective disorders) experience significantly higher rates of morbidity compared with individuals of similar ages without these conditions. Among this broad population, the most vulnerable are Latinxs living with SMI who are not engaged in treatment. Further, trauma among people with SMI, in general, is four to five times higher than for the general public, with highest rates among Latinxs in comparison to other racial and ethnic groups. Despite the availability of effective mental health treatment interventions, approximately 47% of Latinx adults with SMI are not engaged in treatment. Those who are engaged have significantly lower rates of treatment adherence, retention, and satisfaction than White people. Barriers to treatment engagement for Latinxs include lack of bilingual and bicultural clinical providers, the absence of culturally responsive interventions, lack of access to specialty services in Latinx neighborhood, self-reliant attitudes, and cultural differences that impact the recognition of mental health concerns. Some evidence suggests that culturally tailoring interventions to Latinxs may improve treatment engagement. The proficient use of Motivational Interviewing (MI), an evidence-based and person-centered treatment approach, has been shown to predict behavior change, such as treatment engagement, greater medication adherence and reductions in alcohol consumption, and additional outcomes among Latinxs. However, no research to date has examined the cultural adaptation of the MI spirit or the full approach. To fully integrate Latinx cultural values and MI, we need to pay attention not just to the intervention, but also to the method of service delivery. Latinx peers may be in the best position to deliver MI to Latinxs with SMI, given their lived experience with both the culture and the illness. Of the available research on Latinx peers in recovery from SMI, evidence suggests that Latinx peer navigators appear to enhance service engagement, recovery, and quality of life for Latinxs in recovery from a SMI. Therefore, the overall objective of this career development proposal is to culturally adapt MI to integrate Latinx cultural relational values and trauma informed care for delivery by peers in recovery from SMI to engage Latinxs with SMI in mental health treatment. Specifically, the proposed research will 1) identify social and cultural factors that contribute to mental health treatment hesitancy and engagement among Latinxs with SMI; 2) culturally adapt an MI treatment engagement intervention that is trauma informed and peer delivered for Latinxs with SMI; and 3) provide evidence of the feasibility, acceptability, and engagement of target mechanisms associated with the intervention. My mentors, in combination with a world-class training environment at Yale University, will guide me towards my goal of becoming an independent bicultural and bilingual investigator of multi-level influences on mental health inequities, with expertise in designing and conducting rigorous, pragmatic research aimed at improving engagement, care, and clinical outcomes for Latinxs and other racial and ethnic communities.

程序摘要/摘要 患有严重精神疾病的人（SMI；精神病和主要情感障碍）经历了显着的经历 与没有这些条件的相似年龄的个体相比，发病率更高。在这个广阔的地方 人口，最脆弱的人是与SMI一起生活的拉丁裔，他们没有从事治疗。此外，创伤 一般而言，在有SMI的人中，比率是公众的四到五倍，比率最高 与其他种族和族裔相比，拉丁裔在拉丁裔中。尽管有效的精神可用 健康治疗干预措施，大约47％的Latinx成年人没有从事治疗。 那些参与的人的治疗效率明显低于 白人。拉丁裔治疗参与的障碍包括缺乏双语和双文化临床 提供者，缺乏文化反应迅速的干预措施，缺乏拉丁裔的专业服务 邻里，自力更生的态度以及影响认识心理健康的文化差异 关注。一些证据表明，对拉丁裔的文化调整干预措施可以改善治疗 订婚。熟练使用动机访谈（MI），这是一种基于循证和以人为本的 治疗方法已被证明可以预测行为改变，例如治疗参与，更大 用药依从性和饮酒量的减少以及拉丁裔之间的额外结果。 但是，迄今为止尚无研究检查MI精神或完整方法的文化适应。完全 整合拉丁文文化价值和MI，我们不仅需要注意干预措施，还要关注 服务交付方法。 Latinx同龄人可能处于最佳位置，将MI传递给Latinxs smi，给予 他们对文化和疾病的生活经验。关于拉丁裔同伴的可用研究 从SMI恢复，有证据表明拉丁裔同伴导航器似乎可以增强服务参与度， 从SMI恢复的拉丁裔的恢复和生活质量。因此，这个职业的总体目标 发展建议是在文化上适应MI，以整合拉丁文文化关系价值和创伤知情 护理同龄人从SMI恢复的交付，以使Latinxs与SMI进行心理健康治疗。 具体而言，拟议的研究将1）确定有助于心理健康的社会和文化因素 拉丁裔与SMI的犹豫和互动； 2）文化适应MI治疗 与SMI一起为Latinxs提供了创伤和同伴的参与干预措施； 3）提供 与该目标机制相关的目标机制的可行性，可接受性和参与的证据 干涉。我的导师，结合耶鲁大学的世界一流培训环境，将指导 我朝着成为多层影响的独立双语和双语研究者的目标 关于心理健康不平等，具有设计和进行严格的务实研究方面的专业知识 改善拉丁裔以及其他种族和种族社区的参与，护理和临床成果。