Advancing the Early Psychosis Intervention Network in Texas (EPINET-TX)

推进德克萨斯州早期精神病干预网络 (EPINET-TX)

• 批准号: 10261522
• 负责人: Molly A. Lopez
• 金额: $ 137.31万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-11 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10261522
• 关键词: Address; Administrator; Adolescence; African American; Caring; Clinical; Communities; Complex; Data; Data Management Resources; Databases; Decision Making; Development; Disease; Effectiveness; Ensure; Environment; Family; Feedback; Funding; Goals; Grant; Health Personnel; Health Services Research; Healthcare; Healthcare Systems; Hospitals; Individual; Informatics; Information Systems; Infrastructure; Intervention; Knowledge; Latinx; Lead; Learning; Link; Literature; Measurement; Measures; Medical Care Costs; Mental Health; Mental disorders; Methodology; Modeling; Motivation; National Institute of Mental Health; Outcome; Outcome Measure; Participant; Perception; Persons; Pilot Projects; Policy Maker; Population; Practice based research; Procedures; Process; Provider; Psychoses; Quality of life; Randomized; Recovery; Recovery of Function; Relapse; Reporting; Research; Research Infrastructure; Research Personnel; Role; Schizophrenia; Series; Service provision; Services; Site; Social Functioning; Specialist; Symptoms; System; Technology; Texas; Therapeutic; Time; Treatment outcome; United States; Work; acceptability and feasibility; base; behavior change; brief intervention; care systems; community based participatory research; data sharing; design; disability; effective intervention; effective therapy; first episode psychosis; flexibility; functional outcomes; improved outcome; informatics tool; innovation; interest; intervention program; learning progression; medical specialties; medication compliance; new technology; peer; peer support; prevent; primary outcome; programs; prospective; psychotic symptoms; rapid growth; recruit; reduce symptoms; reduced substance use; secondary outcome; service delivery; substance use; success; symptomatology; treatment as usual; treatment program; years lived with disability; young adult

PROJECT SUMMARY/ABSTRACT Coordinated specialty care (CSC) has been shown to be more effective for the treatment of first episode psychosis (FEP) than usual care, resulting in better functioning, fewer symptoms, fewer relapses, and less hospital use. The number of CSC teams has increased dramatically in the U.S. since federal funding has been provided to support states' implementation; Texas currently has 26 CSC teams. This rapid growth of early psychosis intervention programs, operating with similar core features and serving similar participants, provides a unique opportunity. By utilizing a standard battery of reliable service and outcome measures, a data informatics system to facilitate shared data and feedback, and staffing to support quality improvement and research infrastructure, Texas can create an environment in which providers, program administrators, and policy makers can continuously develop new knowledge. The regional network will link programs together through the Texas FEP Consortium, support a culture of measurement-based care, and create a framework for addressing research questions that impact the service delivery system, contribute to the research literature, and reduce the burden of psychosis on young people and their families. Research in persons with FEP has shown that co-occurring substance use is common and can lead to an exacerbation of psychotic symptoms, decreased medication adherence, and poorer long-term outcomes. Research has shown that between 23% and 73% of individuals in FEP programs continue to use substances after 6 to 12 months in care. While CSC models have incorporated practices from brief intervention and treatment models to address substance use, little is known about the use of these strategies in community- based programs or their effectiveness in motivating this group of young people to reduce or stop use. The series of proposed studies will advance an understanding of critical issues for addressing substance use in young people who continue use after entering care. The first study will use a chart review approach to examine whether standard CSC-model interventions are successful at engaging participants in behavior change and the extent to which diverse participants (e.g., African American, Latinx) directly identify reduced substance use as a goal. Qualitative studies will examining the perceptions of CSC participants and CSC peer specialists on the feasibility and acceptability of peer-led interventions for supporting substance use recovery. After partnering with peer specialists and individuals receiving CSC services to develop the intervention, a pilot study will be conducted to examine the feasibility of deployment, study recruitment, retention, and other study procedures. This work will set the stage for a statewide partnership with researchers, decision-makers, providers, young people and their families to become a healthcare system that uses data to continuously learn and transform.

项目概要/摘要 协调专业护理 (CSC) 已被证明对于治疗首发症状更有效 精神病 (FEP) 比常规护理更好，功能更好，症状更少，复发更少，并且更少 医院使用。自联邦政府资助以来，美国 CSC 团队的数量急剧增加 提供支持各国的实施；德克萨斯州目前有 26 支 CSC 团队。这种早期的快速增长 精神病干预计划具有相似的核心特征并为相似的参与者提供服务，提供 一个独特的机会。通过利用可靠服务和结果测量的标准电池组，数据 信息系统以促进共享数据和反馈，以及人员配置以支持质量改进和 研究基础设施，德克萨斯州可以创造一个环境，让提供者、项目管理者和 政策制定者可以不断开发新知识。区域网络将把各个项目连接在一起 通过德克萨斯州 FEP 联盟，支持基于测量的护理文化，并创建一个框架 解决影响服务提供系统的研究问题，为研究文献做出贡献， 减轻年轻人及其家庭的精神病负担。 对 FEP 患者的研究表明，同时使用物质很常见，并且可能导致 精神病症状恶化、药物依从性降低以及长期预后较差。 研究表明，FEP 计划中 23% 到 73% 的人继续使用物质 经过 6 至 12 个月的护理后。虽然 CSC 模型结合了短暂干预和 解决药物使用问题的治疗模式，人们对这些策略在社区中的使用知之甚少—— 基于的计划或其在激励这群年轻人减少或停止使用方面的有效性。这 一系列拟议的研究将增进对解决物质使用问题的关键问题的理解 进入护理机构后继续使用的年轻人。第一项研究将使用图表审查方法来检查 标准 CSC 模型干预是否成功地让参与者参与行为改变以及 不同参与者（例如非洲裔美国人、拉丁裔）直接将减少药物使用视为 一个目标。定性研究将考察 CSC 参与者和 CSC 同行专家对 支持药物使用回收的同行主导干预措施的可行性和可接受性。合作后 与同行专家和接受 CSC 服务的个人一起制定干预措施，将进行一项试点研究 旨在审查部署、研究招募、保留和其他研究程序的可行性。 这项工作将为与研究人员、决策者、提供者、年轻人建立全州合作伙伴关系奠定基础 人们及其家人成为一个使用数据不断学习和转型的医疗保健系统。