Improving Engagement among Families Experiencing First-Episode Psychosis

改善首发精神病家庭的参与度

• 批准号: 10241941
• 负责人: Oladunni Oluwoye
• 金额: $ 15.48万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10241941
• 关键词: Address; Advisory Committees; Age; Assertiveness; Caring; Client; Communication; Conflict (Psychology); Cultural Sensitivity; Data; Development; Effectiveness; Enrollment; Ensure; Evaluation; Evidence based practice; Exhibits; Family; Family member; Feasibility Studies; Focus Groups; Funding; Goals; Health Care Costs; Health Services; Healthcare; Individual; Intervention; Intervention Studies; Life Expectancy; Light; Logistics; Mental Health; Mentored Research Scientist Development Award; Mentorship; Methodology; Modification; Motivation; National Institute of Mental Health; Outcome; Patients; Play; Psychoses; Public Health; Quality of life; Randomized; Recommendation; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Research Support; Schedule; Schizophrenia; Self Determination; Site; Surveys; Testing; Training; Training Activity; Washington; Work; Youth; acceptability and feasibility; barrier to care; base; career; career development; design; effective intervention; ethnic minority population; evidence base; experience; family support; first episode psychosis; implementation framework; implementation science; improved; improved outcome; intervention mapping; medical specialties; multi-site trial; programs; psychiatric symptom; psychoeducation; racial and ethnic disparities; racial minority; recruit; satisfaction; secondary analysis; theories; therapy design; treatment as usual; young adult

ABSTRACT Coordinated specialty care (CSC) interventions have demonstrated effectiveness in improving the short- and long-term outcomes of youth and young adults for first-episode psychosis (FEP). Youth with FEP have better outcomes when their families are involved in care. As a result, all CSC interventions for FEP include family psychoeducation as a core evidence-based component. Despite this fact, CSC programs generally report low levels (<50%) of engagement in family psychoeducation, and engagement of racial and ethnic minority families is even lower (<20%). Lack of family involvement is often driven by low motivation, cultural, logistical, and perceptual barriers, and perceived irrelevance of treatment. My preliminary findings among families of youth with FEP indicate that family members desired frequent communication and positive exchanges with clinicians and more assertive engagement and support. The proposed mixed-methods research project will further document the barriers to CSC. Using this information and input from a family and client Advisory Committee, I will develop, implement, and pilot-test a brief clinician-led family engagement intervention that will coincide with family psychoeducation for CSC programs for youth experiencing FEP. The framework for this study will blend core components of the Promoting Action on Research Implementation in Health Services (PARiHS), a collaborative implementation framework, and Intervention Mapping to ensure that the family engagement intervention fits within the context of CSC programs. The survey of family barriers and the family engagement intervention will be grounded in the Self-Determination Theory. I will first survey 200 family members of patients receiving CSC and assess demographic, cultural, perceptual, and logistical barriers and motivators that influence engagement in CSC programs for FEP. Then I will develop and assess the feasibility of the family engagement intervention in a CSC program and make modifications to improve the intervention. Finally, I will conduct a site-based stepped-wedge trial with 50 family members of youth with FEP recruited from five CSC programs to assess intervention acceptability and feasibility, as well as the impact of the intervention on engagement. The proposed study has the potential to address family engagement issues, with important implications for CSC programs and improved FEP outcomes for clients that will be further tested in a subsequent large R01 study. My proposed research plan integrates activities, formal training, and mentorship from experts (Drs. Michael McDonell, Leopoldo Cabassa, Michael Compton, Roberto Lewis-Fernández, Sterling McPherson, and Dennis Dyck) in FEP, family-focused evidence-based practices, family engagement, implementation science, and mixed- methodology. This Mentored Research Scientist Development Award ( K01) will build upon my previous training to allow me to pursue my long-term career goal to become an independent investigator with an established program of research focused on the development and implementation of effective family-focused evidence- based practices for FEP programs with an underlying emphasis on racial and ethnic disparities.

抽象的 协调专业护理 (CSC) 干预措施已证明在改善短期护理方面有效 患有首发精神病 (FEP) 的青少年和年轻人的长期结果更好。 因此，所有 CSC 的 FEP 干预措施都包括家庭。 尽管如此，CSC 项目的报告普遍较低。 家庭心理教育的参与程度（<50%），以及少数民族家庭的参与程度 缺乏家庭参与的比例甚至更低（<20%）。 知觉障碍，以及我对患有此类疾病的青少年家庭的初步发现。 FEP表示，家属希望与家属经常沟通、积极交流。 拟议的混合方法研究项目将进一步记录。 利用这些信息以及家庭和客户咨询委员会的意见，我将制定： 实施并试点一项由临床医生主导的简短家庭参与干预措施，该干预措施将与家庭 针对经历 FEP 的青少年的 CSC 心理教育项目 本研究的框架将融合核心内容。 促进卫生服务研究实施行动 (PARiHS) 的组成部分， 实施框架和干预规划，以确保家庭参与干预措施适合 在 CSC 计划的背景下，将进行家庭障碍调查和家庭参与干预。 以自我决定理论为基础，我将首先对 200 名接受 CSC 的患者家属进行调查。 并评估影响参与的人口、文化、感知和后勤障碍和动机 然后我将制定并评估家庭参与干预的可行性。 最后，我将进行基于站点的干预。 对从五个 CSC 项目中招募的 50 名持有 FEP 的青少年家庭成员进行阶梯楔形试验进行评估 干预的可接受性和可行性，以及干预对参与的影响。 研究有可能解决家庭参与问题，对 CSC 项目和 为客户改进的 FEP 结果将在我提议的后续大型 R01 研究中得到进一步测试。 研究计划整合了活动、正式培训和专家指导（迈克尔·麦克唐纳博士， 莱奥波尔多·卡巴萨、迈克尔·康普顿、罗伯托·刘易斯·费尔南德斯、斯特林·麦克弗森和丹尼斯·戴克） FEP、以家庭为中心的循证实践、家庭参与、实施科学和混合- 方法论。 指导研究科学家发展奖（ K01）将以我之前的培训为基础 让我能够追求我的长期职业目标，成为一名具有既定地位的独立调查员 研究计划的重点是开发和实施有效的以家庭为中心的证据- FEP 项目的基础实践，重点强调种族和民族差异。