A Promotora-centric Community Collaborative to Improve Connections to Mental Health Services

以 Promotora 为中心的社区合作，以改善与心理健康服务的联系

• 批准号: 10597930
• 负责人: DEBRA L KAYSEN
• 金额: $ 116.52万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-18 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10597930
• 关键词: Accountability; Address; Caring; Characteristics; Chronic; Cluster randomized trial; Collaborations; Communities; Community Health Education; Community Health Services; Community Surveys; Cross-Sectional Studies; Data; Data Collection; Data Sources; Educational Curriculum; Expectancy; Fostering; Geographic Information Systems; Goals; Health; Health Services Accessibility; Individual; Intervention; Interview; Knowledge; Latinx; Latinx population; Lead; Learning; Legal Status; Maps; Measures; Mental Health; Mental Health Services; Mental disorders; Methods; Mission; Modeling; National Institute of Mental Health; Outcome; Pathway Analysis; Pathway interactions; Patient Self-Report; Plant Roots; Population; Prevalence; Provider; Public Health; Research; Role; Self Efficacy; Services; Social Characteristics; Social Network; Structure; Survivors; Target Populations; Testing; Training; Trauma; Trust; Underserved Population; Violence; Voice; Work; base; community barrier; community engagement; community-level factor; cultural competence; design; disparity reduction; diverse data; efficacy outcomes; health care delivery; health care disparity; health disparity; health empowerment; health literacy; health service use; help-seeking behavior; improved; innovation; insight; mental health education; outreach; patient population; post intervention; prevent; social influence; social stigma; trend; underserved community

PROJECT SUMMARY / ABSTRACT Almost 70% of Latinx people with mental health disorders fail to receive the treatment they need due to various barriers to accessing culturally specific mental health care. We propose that particularly trusted voices might be able to decrease mental health stigma in their communities and strengthen social networks to improve mental health services connections. In Spanishspeaking communities, lay health workers called promotoras fulfill this role: promotoras act as educators, cultural brokers, and bridges between the community and health services. We will engage with a promotora learning collaborative to develop and assess a community-wide mental health education and empowerment campaign to increase culturally specific knowledge of mental health, trauma, and support services and to improve mental health services utilization in the Latinx population of East San José, CA. By collaborating with deep-rooted community partners, we seek to achieve the following specific aims: 1) Map the landscape of and pathways to mental health services within the community; 2) Strengthen promotoras’ capacity to engage their community around mental health services use; and 3) Determine if engaging promotoras in a mental health education and empowerment campaign increases mental health services utilization community-wide. Under the first aim, we will work with community partners and promotoras to create a rich community asset map of culturally specific mental health services, layered with findings from a community-wide assessment of mental health services use, using geographic information system mapping (GIS). Promotoras will then be trained to facilitate Mental Health Education, (self-)Efficacy, and (outcomes) Expectancy (MHE3) gatherings – a co-created culturally specific intervention to improve mental health services use. Finally, in the third aim, we will implement MHE3 as a cluster randomized trial and determine its impact at the individual, interpersonal, and community levels. Beyond self-reported outcomes, we will investigate the impact on social networks used to identify and choose mental health services. We will combine findings from existing facility-based and claims data with the results of a newly collected annual cross-sectional survey of the community to determine broader community-level impact on mental health services use. Understanding how promotoras help overcome barriers to mental health and services use will deliver insights that inform collaboration with and integration of promotoras into care pathways and delivery strategies to decrease mental health disparities among Latinx communities more widely. Furthermore, we believe this work can also serve as a template for how to conduct outreach to other underserved populations. Finally, the proposed research will further NIMH’s mission to strengthen the public health impact of research by testing innovating approaches to reduce disparities in care access.

项目摘要 /摘要 由于各种 获得文化特定精神卫生保健的障碍。 我们建议特别值得信赖的声音可能能够减少他们的心理健康污名 社区并加强社交网络以改善心理健康服务联系。在西班牙语社区中，外行卫生工作者称为发起人扮演这一角色：发起人作为教育者， 文化经纪人以及社区与卫生服务之间的桥梁。 我们将与Proportora学习合作伙伴互动，以发展和评估社区范围的心理健康 教育和赋权运动，以增加对心理健康，创伤和 支持服务并改善东圣何塞（EastSanjosé）拉丁裔人口的心理健康服务利用， 大约通过与根深蒂固的社区合作伙伴合作，我们寻求实现以下特定目标：1） 绘制社区内心理健康服务的景观和途径； 2）加强 发起人围绕精神卫生服务使用社区的能力； 3）确定是否 让促进者参与心理健康教育和赋权运动可以增加心理健康 服务范围内服务利用。 在第一个目标下，我们将与社区合作伙伴和发起人合作，创建丰富的社区资产 具有文化特定精神卫生服务的地图，并从社区范围的评估中进行了分层 心理健康服务使用地理信息系统映射（GIS）。然后，促销将是 经过培训，可以促进心理健康教育，（自我）疗效和（结果）期望（MHE3）聚会 - 共同创建的文化特定干预措施，以改善精神卫生服务的使用。最后，在第三个目标中，我们 将实施MHE3作为群集随机试验，并确定其对个人，人际关系和 社区层面。除了自我报告的结果之外，我们还将调查对过去的社交网络的影响 识别并选择心理健康服务。我们将结合现有基于设施的发现和索赔 与新收集的社区年度横断面调查的结果有关的数据，以确定更广泛的 社区级对心理健康服务使用的影响。 了解发起人如何帮助克服心理健康和服务使用的障碍将提供见解 这些信息与发起人合作并集成到护理途径和交付策略中 更广泛地减少拉丁裔社区的心理健康差异。此外，我们相信这项工作 还可以用作如何向其他服务不足的人群进行宣传的模板。最后， 拟议的研究将进一步通过测试来增强研究的公共卫生影响的使命 创新方法以减少护理访问中的分布。