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

基本信息

批准号：
10673950
负责人：
Oladunni Oluwoye
金额：
$ 23.08万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
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/10673950
关键词：
20 year old Address Administrator Age Area Caring Censuses Characteristics Client Communities Coordinated Specialty Care Credentialing Data Data Set Databases Decision Aid Development Disadvantaged Disparity Early Intervention Effectiveness Environment Equity Ethnic Origin Family Focus Groups Funding Gender Geographic Distribution Geographic Locations Geography Goals Grant Health Services Accessibility Incidence Individual Inequity Internet Link Location Maps Measures Mental Health Mental Health Services National Institute of Mental Health Neighborhoods Outcome Pathway interactions Persons Policies Policy Maker Provider Psychoses Public Health Quality of life Race Racial Segregation Recovery Research Research Support Resources Role Rural Schizophrenia Services Spatial Distribution Structure Techniques Technology Time Transportation Underserved Population Urbanization Variant Visualization Washington Work Youth access disparities built environment care systems dashboard density deprivation disparity reduction duration of untreated psychosis early onset early psychosis economic disparity ethnic diversity evidence base experience first episode psychosis future implementation geographic disparity health determinants health disparity populations improved inequitable distribution medical specialties novel payment programs psychiatric symptom 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 technology development tool

项目摘要

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.

抽象的协调专业护理 (CSC) 是美国早期精神病的护理标准，得到 5- 支持。社区心理健康整笔拨款计划中留出 10%，目标是基于证据的早期干预措施中，大约 350 个 CSC 项目已在美国 49 个州实施。个人居住的社区是健康的重要决定因素，并且大多数现有社区关于社区层面的决定因素和早期精神病的工作重点关注对个人层面的影响因素，例如精神病的发生率和发作，以及未经治疗的精神病的持续时间，但很少研究调查了社区层面的特征作为寻求早期精神病服务的障碍。研究强调了就近提供心理健康服务的重要性个人社区，但对 CSC 的空间分布和可达性知之甚少我们对获得 CSC 的潜在困难的了解存在明显差距。项目以及 CSC 项目的地理位置和分布是否有助于为了解决这一差距，我们拟议研究的总体目标是描述 CSC 计划的特征。并了解我们将创建的 CSC 计划的地域分布和不平等。一个新颖的综合多级地理空间数据库，包含在美国各地实施的 CSC 计划，将包括客户级数据（种族、民族、年龄、性别）、项目级数据（地理编码位置、容量、规模、环境、薪酬、角色可用性）、提供者级别的数据（种族、民族、专业证书），以及社区层面的人口普查数据（居住隔离、种族密度、地区剥夺、城乡连续、宽带互联网订阅、公共交通时间）。我们的具体目标是 1) 描述 CSC 计划的设施级特征因地理位置而异； 2) 检查地理位置；根据社区层面的特点，提供 CSC 计划；以及 3) 制定 CSC 计划；使用网络地图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难以获得 CSC 计划的领域这项拟议的研究代表了一项新颖的研究。先进空间分析的应用将增进对地理不平等的理解 CSC 计划的可访问性，可用于为政策和 CSC 的未来实施提供信息在访问受限的高需求地区开展计划。