Mental Illness Self-Management Through Wellness Recovery Action Planning

通过健康恢复行动计划进行精神疾病自我管理

• 批准号: 7919300
• 负责人: JUDITH A COOK
• 金额: $ 34.71万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-21 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7919300
• 关键词: Administrator; Adoption; Advisory Committees; Advocacy; Advocate; Asthma; Attention; Attitude; Behavior; Behavioral; Belief; Chicago; Chronic; Client; Collaborations; Communities; Competence; Controlled Study; Data; Development; Diabetes Mellitus; Diagnosis; Disease; Eating; Educational process of instructing; Effectiveness; Employment; Exposure to; Family member; Feasibility Studies; Feeling; Future; Goals; Health; Health Food; Health Status; Hour; Human; Illinois; Independent Living; Individual; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Learning; Life; Maintenance; Measures; Medical; Mental Health; Mental disorders; Methods; Modeling; Monitor; Motivation; Outcome; Participant; Patient-Centered Care; Patients; Photography; Placebo Control; Preparation; Preventive; Procedures; Protocols documentation; Provider; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Recruitment Activity; Rehabilitation therapy; Relapse; Reporting; Research; Research Design; Risk Factors; Rural Community; Self Assessment; Self Management; Services; Structure; Surveys; Symptoms; Techniques; Telephone Interviews; Testing; Universities; authority; behavior change; design; experience; follow-up; innovation; member; nutrition; peer; physical conditioning; post intervention; prevent; programs; public health relevance; randomized trial; satisfaction; self esteem; self help; severe mental illness; skills

DESCRIPTION (provided by applicant): The purpose of this R34 application is to conduct a feasibility study in preparation for an R01 application testing Wellness Recovery Action Planning (WRAP) versus an attention-control placebo called Choosing Wellness (CW). WRAP is a peer-led, mental illness self-management intervention developed by people in recovery from psychiatric disorders. While ample evidence supports the efficacy of structured self- management programs for chronic physical conditions such as diabetes and asthma, few rigorous studies have evaluated this approach for mental health disorders. The application has three aims. The first aim is to develop an intervention version of WRAP and an accompanying fidelity assessment suitable for use in a controlled study. The second aim is to adapt the CW intervention for use in this study, along with a fidelity assessment, so that CW can be used as an attention-control placebo intervention for a future large-scale randomized controlled trial. The third aim is to gather pilot data by conducting a small, randomized trial to assess the effectiveness of the WRAP intervention, as well as gather satisfaction and feasibility data from consumer and provider surveys, and use hermeneutic photography procedures to better understand how WRAP influences recovery. The proposed research will use a design in which 132 individuals with severe mental illness will be recruited from three community mental health agencies and randomly assigned to the WRAP (n=66) or attention-control placebo condition (n=66). Subjects will be assessed at study baseline, 6 weeks post-intervention, and at 6-month follow-up. Survey and interview procedures will gather data from each agency's staff and clients to assess intervention acceptability and identify logistical problems. Hermeneutic photography will be used to examine participants' perspectives on how WRAP impacts their lives. The study protocol includes measures of recovery, hope, self-confidence, self-advocacy, peer support, and psychiatric symptoms. A study advisory committee composed of clients and staff from each agency, the creator of WRAP, other WRAP experts, state mental health authority administrators, and family members, will provide input into the study design and assist in interpreting the results in preparation for an R01 application. This project responds to the "Functioning PA" (PA-08-255) released 09/26/08 given its aim "to develop innovative behavioral and ecological interventions that will reduce complications in daily living (e.g., innovative employment strategies, new methods of rehabilitation, or new models of independent living)." PUBLIC HEALTH RELEVANCE: The overall goal of the proposed study is to advance our understanding of how individuals with mental illness can learn to self-manage their symptoms and rebuild productive lives. Established as an effective approach for patients with chronic medical conditions, illness self-management interventions have the potential to be an important adjunct to traditional mental health treatment, and serve a tertiary preventive function by preventing relapse once treatment has ended. We hope that this type of program can further our nation's public health goal of recovery for significant proportions of citizens diagnosed with serious mental illness.

描述（由申请人提供）：此 R34 申请的目的是进行可行性研究，为测试健康恢复行动计划 (WRAP) 与称为选择健康 (CW) 的注意力控制安慰剂的 R01 应用做准备。 WRAP 是一种由同伴主导的精神疾病自我管理干预措施，由精神疾病康复者开发。虽然充足的证据支持结构化自我管理计划对糖尿病和哮喘等慢性身体疾病的有效性，但很少有严格的研究评估这种方法对精神健康障碍的影响。该应用程序有三个目标。第一个目标是开发 WRAP 的干预版本以及适用于对照研究的随附保真度评估。第二个目标是调整 CW 干预措施以用于本研究，并进行保真度评估，以便 CW 可以用作未来大规模随机对照试验的注意力控制安慰剂干预措施。第三个目标是通过进行小型随机试验来收集试点数据，以评估 WRAP 干预的有效性，并从消费者和提供者调查中收集满意度和可行性数据，并使用解释摄影程序更好地了解 WRAP 如何影响恢复。拟议的研究将采用一种设计，从三个社区心理健康机构招募 132 名患有严重精神疾病的个体，并随机分配到 WRAP（n = 66）或注意力控制安慰剂条件（n = 66）。受试者将在研究基线、干预后 6 周以及 6 个月随访时接受评估。调查和访谈程序将从每个机构的工作人员和客户那里收集数据，以评估干预措施的可接受性并确定后勤问题。将使用诠释学摄影来研究参与者对 WRAP 如何影响他们生活的看法。研究方案包括康复、希望、自信、自我倡导、同伴支持和精神症状的衡量标准。由每个机构的客户和工作人员、WRAP 的创建者、其他 WRAP 专家、州精神卫生当局管理人员和家庭成员组成的研究咨询委员会将为研究设计提供意见，并协助解释结果，为 R01 做准备应用。该项目响应 2008 年 9 月 26 日发布的“功能性 PA”(PA-08-255)，其目标是“开发创新的行为和生态干预措施，减少日常生活中的复杂情况（例如，创新的就业策略、新的就业方法）康复，或独立生活的新模式）。” 公共卫生相关性：拟议研究的总体目标是增进我们对精神疾病患者如何学会自我管理症状并重建富有成效的生活的理解。疾病自我管理干预措施被认为是慢性病患者的有效方法，有可能成为传统心理健康治疗的重要辅助手段，并通过在治疗结束后防止复发来发挥三级预防功能。我们希望此类计划能够进一步促进我国大部分被诊断患有严重精神疾病的公民康复的公共卫生目标。