A Family Peer Navigator Model to Increase Access and Initial Engagement in Coordinated Specialty Care Programs Among Black Families

家庭同伴导航模型，以增加黑人家庭对协调专业护理计划的访问和初步参与

• 批准号: 10597673
• 负责人: Oladunni Oluwoye
• 金额: $ 26.78万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10597673
• 关键词: 20 year old; Address; Administrator; African American; African American population; Area; Black Populations; Black race; Caring; Clinical; Communities; Coordinated Specialty Care; Data; Development; Diagnosis; Discrimination; Effectiveness; Enrollment; Equity; Ethnic Origin; Evidence based treatment; Family; Family member; Feedback; Formulation; Goals; Health; Health Personnel; Health Services Research; Improve Access; Individual; Inequity; Intake; Intensive Care; Intervention; Intervention Studies; Interview; Knowledge; Mental Health; Mental Health Services; Methods; Modeling; National Institute of Mental Health; Outcome; Pathway interactions; Persons; Phase; Play; Population Heterogeneity; Process; Provider; Psychoses; Public Health; Quality of life; Race; Randomized; Reporting; Research; Research Support; Role; Sampling; Schizophrenia; Self Efficacy; Services; Telephone; Time; Training; Washington; Youth; active control; care coordination; care providers; design; disparity reduction; duration of untreated psychosis; early psychosis; effectiveness/implementation hybrid; ethnic disparity; ethnic minority; evidence base; experience; first episode psychosis; functional outcomes; health service use; implementation outcomes; implementation process; implementation strategy; improved; informant; innovation; loved ones; model design; peer; pilot test; pilot trial; programs; psychiatric symptom; psychoeducation; psychoeducational; psychosis risk; racial disparity; racial minority; randomized trial; recruit; social; telephone based; theories; treatment comparison

ABSTRACT Family members have a key role in facilitating the initiation of mental health services. Yet, Black/African American families often encounter barriers and experience delays accessing coordinated specialty care programs. These delays can be attributed to individual (e.g., knowledge), interpersonal (e.g., connectedness), community (e.g., access), and societal (e.g., discrimination) factors. In other health related areas, peer navigator models improve access to much needed services and promote more positive experiences among individuals and their families. However, there are have been no family peer navigator models developed to address the complexities that impact Black/African American families to improve access to coordinated specialty care programs. Preliminary research suggests approximately 70% of Black/African American family members report no contact with clinicians prior to initial diagnosis and the receipt of services for early psychosis. Among Black/African Americans, family member engagement prior to services and during treatment for first episode psychosis significantly impacts clinical and functional outcomes among youth enrolled in coordinated specialty care programs. Building upon formative research, this mixed methods study will be conducted in three phases to develop, refine, and pilot-test a multi-component Family Peer Navigator model designed to increase access and engagement in coordinated specialty care programs Black families. A community advisory board will provide feedback during each Phase II and III to refine the navigator model. The Family Peer Navigator model will utilize telephone-based strategies and encompass the Cultural Formulation Interview to tailor family psychoeducation and care coordination. Phase I and Phase II utilize an exploratory-sequential mixed methods design to refine the Family Peer Navigator model and implementation strategy. Phase I involves qualitative interviews with coordinated specialty care directors and providers, and agency-level administrators. Phase II is a 4-month open trial that will recruit up to 10 Black families. Phase III will consist of an embedded mixed methods designed randomized pilot trial of the Family Peer Navigator model against a low-intensive care coordination in two coordinated specialty care programs. The acceptability, feasibility, and preliminary impact will be assessed in a sample of 40 Black/African American families with a loved one at risk for psychosis or currently experiencing their first episode of psychosis. Other outcomes include proposed treatment targets (self-efficacy, knowledge, social connectedness), preliminary impact outcomes (time to coordinated specialty care programs, initial family engagement), and implementation outcomes (acceptability, feasibility, appropriateness). This study will establish an innovative culturally informed family peer navigator model and generate preliminary data to support a Type II hybrid effectiveness-implementation R01 application.

抽象的 家庭成员在促进精神卫生服务的启动方面发挥了关键作用。但是，黑人/非洲 美国家庭经常会遇到障碍和经验延迟获得协调的专业护理 程序。这些延迟可以归因于个人（例如，知识），人际关系（例如， 联系），社区（例如访问）和社会（例如歧视）因素。在其他与健康有关的 领域，同行导航器模型可改善对急需服务的访问，并促进更多积极的服务 个人及其家人之间的经验。但是，没有家庭同行导航员 开发的模型是为了解决影响黑人/非洲裔美国家庭改善获取的复杂性 协调专业护理计划。初步研究表明，大约70％的黑人/非洲人 美国家庭成员报告在初次诊断之前与临床医生没有联系和接收服务 早期精神病。在黑人/非裔美国人中，服务前和期间的家庭成员参与 第一事件的治疗精神病会显着影响青年的临床和功能结果 参加协调的专业护理计划。在形成性研究的基础上，这项混合方法研究 将分为三个阶段进行开发，完善和实行测试 模型旨在增加黑人家庭协调专业护理计划的访问和参与。 社区顾问委员会将在每个阶段和III期间提供反馈，以完善导航器模型。 家庭同行导航器模型将利用基于电话的策略并涵盖文化 制定面试以量身定制家庭心理教育和护理协调。第一阶段和第二阶段利用 探索性序列混合方法设计，以完善家庭同行导航器模型和实施 战略。第一阶段涉及与协调专业护理总监和提供者的定性访谈，以及 代理级管理员。第二阶段是一个为期4个月的开放式试验，将招募多达10个黑人家庭。阶段 III将由嵌入式混合方法组成，设计了家庭同伴导航器的随机试验试验 在两个协调专业护理计划中反对低强度护理协调的模型。这 将在40个黑人/非裔美国人的样本中评估可接受性，可行性和初步影响 有亲人有精神病风险或目前经历精神病第一集的家庭。其他 结果包括建议的治疗目标（自我效能，知识，社会联系），初步 影响成果（是时候协调专业护理计划，最初的家庭参与），并且 实施结果（可接受性，可行性，适当性）。这项研究将建立创新的 文化知情的家庭同伴导航器模型并生成初步数据以支持II型混合动力车 有效性实施R01应用。