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 协调的专业护理（CSC）干预措施表明，在改善短暂的方面有效 以及年轻人和年轻人的长期结局，用于第一集精神病（FEP）。 FEP的青年有更好 当他们的家人参与护理时的结果。结果，FEP的所有CSC干预措施都包括家庭 心理教育作为核心证据的组成部分。尽管这一事实，CSC计划通常报告低 参与家庭心理教育以及种族和少数民族家庭的参与度（<50％） 较低（<20％）。缺乏家庭参与通常是由动力低下，文化，文化和 感知障碍和对治疗无关的感知。我在青年家庭中的初步发现 FEP表明，家庭成员希望经常与临床医生进行沟通和积极交流 更自信的参与和支持。拟议的混合方法研究项目将进一步证明 CSC的障碍。使用家庭和客户咨询委员会的这些信息和意见，我将开发， 实施，并进行简短的临床主导家庭参与干预措施，与家人一致 CSC计划的心理教育。这项研究的框架将融合核心 促进卫生服务研究实施行动（PARIHS）的组成部分，合作 实施框架和干预映射，以确保家庭参与干预适合 在CSC程序的背景下。家庭障碍和家庭参与干预的调查将 基于自决理论。我将首先调查200名接受CSC的患者的家庭成员 并评估影响参与度的人口，文化，感知和物流障碍和动机 在FEP的CSC程序中。然后，我将开发和评估家庭参与干预的可行性 在CSC计划中，并进行了修改以改善干预措施。最后，我将进行基于站点的 与50名青年家庭成员一起从五个CSC计划中招募的FEP来评估，逐步审判 干预可接受性和可行性，以及干预对参与的影响。提议 研究有可能解决家庭参与问题，对CSC计划和 随后的大型R01研究将进一步测试客户的FEP结果。我提出的 研究计划的综合活动，专家的正式培训和精神训练（迈克尔·麦克唐纳博士， Leopoldo Cabassa，Michael Compton，Roberto Lewis-Fernández，Sterling McPherson和Dennis Dyck） 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。这 指导研究科学家发展奖（ K01）将以我以前的培训为基础 为了让我购买长期职业目标，成为一名拥有既定的独立调查员 研究计划的重点是开发和实施有效以家庭为中心的证据 - FEP计划的基于基本的实践对种族和种族差异的重视。