Mental Illness Self-Management Through Wellness Recovery Action Planning

通过健康恢复行动计划进行精神疾病自我管理

• 批准号: 7737831
• 负责人: JUDITH A COOK
• 金额: $ 35.39万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-21 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7737831
• 关键词: Administrator; Adoption; Advisory Committees; Advocacy; Advocate; Asthma; Attention; Attitude; Behavior; Behavioral; Belief; Chicago; Chronic; Client; Collaborations; Communities; Competence; Controlled Study; Data; Development; Diabetes Mellitus; Diagnosis; Disease; Eating; Educational process of instructing; Effectiveness; Employment; Exposure to; Family member; Feasibility Studies; Feeling; Future; Goals; Health; Health Food; Health Status; Hour; Human; Illinois; Independent Living; Individual; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Learning; Life; Maintenance; Measures; Medical; Mental Health; Mental disorders; Methods; Modeling; Monitor; Motivation; Outcome; Participant; Patient-Centered Care; Patients; Photography; Placebo Control; Preparation; Preventive; Procedures; Protocols documentation; Provider; Public Health; Quality of life; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recovery; Recruitment Activity; Rehabilitation therapy; Relapse; Reporting; Research; Research Design; Risk Factors; Rural Community; Self Assessment; Self Management; Services; Structure; Surveys; Symptoms; Techniques; Telephone Interviews; Testing; Universities; authority; behavior change; design; experience; follow-up; innovation; member; nutrition; peer; physical conditioning; post intervention; prevent; programs; public health relevance; satisfaction; self esteem; self help; severe mental illness; skills

DESCRIPTION (provided by applicant): The purpose of this R34 application is to conduct a feasibility study in preparation for an R01 application testing Wellness Recovery Action Planning (WRAP) versus an attention-control placebo called Choosing Wellness (CW). WRAP is a peer-led, mental illness self-management intervention developed by people in recovery from psychiatric disorders. While ample evidence supports the efficacy of structured self- management programs for chronic physical conditions such as diabetes and asthma, few rigorous studies have evaluated this approach for mental health disorders. The application has three aims. The first aim is to develop an intervention version of WRAP and an accompanying fidelity assessment suitable for use in a controlled study. The second aim is to adapt the CW intervention for use in this study, along with a fidelity assessment, so that CW can be used as an attention-control placebo intervention for a future large-scale randomized controlled trial. The third aim is to gather pilot data by conducting a small, randomized trial to assess the effectiveness of the WRAP intervention, as well as gather satisfaction and feasibility data from consumer and provider surveys, and use hermeneutic photography procedures to better understand how WRAP influences recovery. The proposed research will use a design in which 132 individuals with severe mental illness will be recruited from three community mental health agencies and randomly assigned to the WRAP (n=66) or attention-control placebo condition (n=66). Subjects will be assessed at study baseline, 6 weeks post-intervention, and at 6-month follow-up. Survey and interview procedures will gather data from each agency's staff and clients to assess intervention acceptability and identify logistical problems. Hermeneutic photography will be used to examine participants' perspectives on how WRAP impacts their lives. The study protocol includes measures of recovery, hope, self-confidence, self-advocacy, peer support, and psychiatric symptoms. A study advisory committee composed of clients and staff from each agency, the creator of WRAP, other WRAP experts, state mental health authority administrators, and family members, will provide input into the study design and assist in interpreting the results in preparation for an R01 application. This project responds to the "Functioning PA" (PA-08-255) released 09/26/08 given its aim "to develop innovative behavioral and ecological interventions that will reduce complications in daily living (e.g., innovative employment strategies, new methods of rehabilitation, or new models of independent living)." PUBLIC HEALTH RELEVANCE: The overall goal of the proposed study is to advance our understanding of how individuals with mental illness can learn to self-manage their symptoms and rebuild productive lives. Established as an effective approach for patients with chronic medical conditions, illness self-management interventions have the potential to be an important adjunct to traditional mental health treatment, and serve a tertiary preventive function by preventing relapse once treatment has ended. We hope that this type of program can further our nation's public health goal of recovery for significant proportions of citizens diagnosed with serious mental illness.

描述（由申请人提供）：此R34申请的目的是进行可行性研究，以准备R01申请测试健康恢复行动计划（WRAP）与称为“选择健康（CW）”的注意力控制安慰剂。 Wrap是由人们从精神疾病中康复的人开发的同伴主导的精神疾病自我管理干预措施。尽管有足够的证据支持结构化的自我管理计划对糖尿病和哮喘等慢性身体状况的有效性，但很少有严格的研究评估了这种方法对心理健康疾病的方法。该应用程序有三个目标。第一个目的是开发一个干预版本的包装版本，并提供适合在对照研究中使用的保真度评估。第二个目的是调整CW干预措施，并进行忠诚度评估，以便将CW用作注意力控制的安慰剂干预措施，以进行未来的大规模随机对照试验。第三个目的是通过进行一项小型的随机试验来收集试点数据，以评估包装干预的有效性，并从消费者和提供商调查中收集满意度和可行性数据，并使用诠释学的摄影程序来更好地了解包装的恢复如何影响恢复。拟议的研究将使用一种设计，其中将从三个社区心理健康机构中招募132名严重精神疾病的人，并随机分配给包裹（n = 66）或注意力控制安慰剂条件（n = 66）。受试者将在研究基线，干预后6周和6个月的随访中进行评估。调查和访谈程序将收集每个机构的员工和客户的数据，以评估干预可接受性并确定后勤问题。诠释学摄影将用于研究参与者对包裹如何影响他们生活的观点。研究方案包括恢复，希望，自信心，自我顾问，同伴支持和精神病症状的度量。由每个机构的客户和员工组成的研究咨询委员会，Wrap的创建者，其他包装专家，州心理卫生管理局管理员和家人，将提供研究设计的意见，并协助解释结果，以准备R01应用。该项目响应“运行PA”（PA-08-255）发布了09/26/08的目标，其目的是“开发创新的行为和生态干预措施，以减少日常生活的并发症（例如，创新的就业策略，新的方法，新的方法康复或独立生活的新模式）。” 公共卫生相关性：拟议研究的总体目标是促进我们对精神疾病个人如何学习症状并重建生产力生活的理解。疾病自我管理干预措施是作为患有慢性病患者的有效方法，有可能成为传统心理健康治疗的重要辅助手段，并通过防止治疗结束后防止复发来发挥高等预防功能。我们希望这种类型的计划能够进一步促进我们国家的公共卫生目标，以恢复大量被诊断出患有严重精神疾病的公民。