Impact of peer Support on Health Services and Social Disparities Among Minority Youth with SMI

同伴支持对患有 SMI 的少数族裔青年的卫生服务和社会差异的影响

基本信息

批准号：
9899755
负责人：
VICTORIA D OJEDA
金额：
$ 59.01万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-20 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9899755
关键词：
Address Administrator Adult African American Age Alcohol or Other Drugs use Area Asses California Client Communities Cost Analysis Cost Savings County Data Development Educational Status Effectiveness Emergency medical service Empathy Employment Ethnic group Exhibits Face Feeling suicidal Focus Groups Funding Goals Group Interviews Health Health Services Health Services Accessibility Health system Healthcare Homelessness Housing Imprisonment Improve Access Income Individual Inpatients Intervention Interview Justice Latino Link Los Angeles Mental Depression Mental Health Mental Health Services Mentors Mentorship Methods Minority Outcome Perception Policy Maker Population Poverty Provider Quality of Care Race Recommendation Research Resources Self Efficacy Services Social support Suicide attempt Surveys System Taxes Time Treatment outcome Trust Underserved Population Unemployment Youth cost disparity reduction effectiveness testing evidence base evidence based guidelines experience foster care health care service health disparity health service use improved interest minority health outpatient programs peer peer support preference programs racial and ethnic disparities severe mental illness social social disparities treatment comparison unintended pregnancy virtual

项目摘要

Project Summary/Abstract This mixed methods study aims to assess whether peer-support reduces disparities in mental health service utilization and social outcomes among transitional age youth (TAY) age 16-24 with severe mental illness (SMI). TAY with SMI face extraordinary challenges in their transition to adulthood and exhibit lower levels of educational attainment, and higher rates of unemployment, poverty, unplanned pregnancy, substance use, homelessness, and justice system involvement than TAY without SMI. These disparities are exacerbated among minority TAY. Therefore, there is a great need for evidence-based, culturally tailored interventions that effectively link TAY to resources that can improve their mental health and social outcomes. The 2004 California Mental Health Services Act funded hundreds of new TAY-specific programs; while TAY peer support services are now pervasive in mental health programs, evidence regarding their effectiveness for TAY with SMI is largely lacking. Therefore, this study aims to (1) Estimate quantitatively whether the use of peer support reduces racial / ethnic disparities in mental health services and social outcomes among TAY living with SMI; (2) Identify quantitatively which types or combinations of peer supports are most effective at improving mental health services and social outcomes and reducing racial / ethnic disparities among TAY; (3) Estimate the additional mental health service costs or cost savings associated with providing peer support services to TAY; (4) Qualitatively elucidate TAY clients’ and peer providers’ perceptions of how TAY peer support relates to mental health services and social outcomes disparities; and (5) Qualitatively characterize barriers and facilitators to the use of TAY peer support by TAY program managers and county administrators. To meet these aims, we will survey TAY programs (N=140), analyze five years of administrative data to assess costs or cost-savings associated with using peer support services (N=8,800, Aims 1-3) and conduct small group interviews with TAY peer providers (n=30-40), focus groups with TAY clients (n=60-80), and individual interviews with as TAY program managers (n=20) and county administrators (n=6-10) (Aims 4 and 5). This study leverages a major system redesign in California’s mental health system and aims to rigorously study a large-scale implementation of TAY peer support services. Findings will help providers and policy-makers make informed decisions about the effectiveness of peer support in reducing disparities among minority TAY living with SMI and enable us to make recommendations on potential best-practices in the use of TAY peer supports.

项目概要/摘要这项混合方法研究旨在评估同伴支持是否可以减少心理健康服务的差异 16-24 岁患有严重精神疾病 (SMI) 的过渡年龄青年 (TAY) 的利用和社会结果。患有 SMI 的 TAY 在向成年过渡的过程中面临着非凡的挑战，并且表现出较低的水平教育程度，以及更高的失业率、贫困率、意外怀孕率、药物滥用率、与没有 SMI 的 TAY 相比，无家可归者和司法系统参与情况更加严重。因此，非常需要基于证据的、针对文化的干预措施。有效地将 TAY 与可以改善其心理健康和社会成果的资源联系起来 2004 年加利福尼亚州。《心理健康服务法》资助了数百个新的 TAY 特定项目，同时 TAY 同伴支持服务；现在在心理健康项目中普遍存在，有关其对 TAY 和 SMI 的有效性的证据是因此，本研究的目的是（1）定量估计是否使用同伴支持。减少患有 SMI 的 TAY 心理健康服务和社会结果方面的种族/民族差异； (2) 定量地确定哪些类型或同伴支持的组合对于改善心理最有效卫生服务和社会成果以及减少 TAY 之间的种族/民族差异 (3) 估计额外的心理健康服务费用或与向 TAY 提供同伴支持服务相关的费用节省； (4) 定性地阐明 TAY 客户和同行提供商对 TAY 同行支持如何相关的看法心理健康服务和社会结果的差异；以及 (5) 定性描述障碍和 TAY 项目经理和县行政人员利用 TAY 同伴支持的促进者。为了实现这些目标，我们将调查 TAY 计划（N=140），分析五年的行政数据以评估成本或与使用同伴支持服务（N=8,800，目标 1-3）和开展小组活动相关的成本节约与 TAY 同行提供商的访谈 (n=30-40)、与 TAY 客户的焦点小组访谈 (n=60-80) 以及个人与 TAY 项目经理 (n=20) 和县行政人员 (n=6-10) 进行访谈（目标 4 和 5）。这项研究利用了加州心理健康系统的重大系统重新设计，旨在严格研究大规模实施 TAY 同伴支持服务的调查结果将帮助提供者和政策制定者做出决定。关于同伴支持在减少少数民族 TAY 生活差异方面的有效性做出明智的决定与 SMI 合作，使我们能够就使用 TAY 同行支持的潜在最佳实践提出建议。