Effectiveness of an intervention in increasing the provision of preventive care by community mental health services: a non-randomized, multiple baseline implementation trial.
Effectiveness of an intervention in increasing the provision of preventive care by community mental health services: a non-randomized, multiple baseline implementation trial.
复制标题
DOI：
10.1186/s13012-016-0408-4
复制
发表时间：
2016-04-02
期刊：
影响因子：
--
通讯作者：
Wiggers J
中科院分区：
文献类型：
--
作者：
Bartlem KM;Bowman J;Freund M;Wye PM;Barker D;McElwaine KM;Wolfenden L;Campbell EM;McElduff P;Gillham K;Wiggers J
与一般人群相比，患有精神疾病的人更有可能有可改变的慢性病健康风险行为。社区精神卫生临床医生通常不会提供降低此类风险的护理。本研究旨在确定一项干预措施的有效性，以增加这些临床医生针对四种慢性病风险行为提供的预防性护理。2011-2014年，在澳大利亚新南威尔士州的两组社区精神卫生服务机构中进行了多基线试验。每组依次实施12个月的实践改变干预。从第一组干预前的6个月到第二组干预后的6个月，在3年的时间里，通过对随机样本的客户进行电话采访，连续收集结果数据。结果是客户报告收到关于吸烟、有害酒精消费、水果和/或蔬菜消费不足和身体活动不足以及四种行为的评估、建议和转诊。逻辑回归分析检查了客户报告的护理收据的变化。干预后对所有风险的综合评估增加（18%至29%；OR 3.55, p = 0.002：基线时n = 805，随访时n = 982）。对每个个体风险的评估、建议或转诊均未发现显著变化。干预措施对增加预防性保健的提供效果有限。需要进一步研究以确定如何在社区精神卫生服务中增加预防性护理的提供。澳大利亚和新西兰临床试验注册中心ACTRN12613000693729
Relative to the general population, people with a mental illness are more likely to have modifiable chronic disease health risk behaviours. Care to reduce such risks is not routinely provided by community mental health clinicians. This study aimed to determine the effectiveness of an intervention in increasing the provision of preventive care by such clinicians addressing four chronic disease risk behaviours. A multiple baseline trial was undertaken in two groups of community mental health services in New South Wales, Australia (2011–2014). A 12-month practice change intervention was sequentially implemented in each group. Outcome data were collected continuously via telephone interviews with a random sample of clients over a 3-year period, from 6 months pre-intervention in the first group, to 6 months post intervention in the second group. Outcomes were client-reported receipt of assessment, advice and referral for tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption and inadequate physical activity and for the four behaviours combined. Logistic regression analyses examined change in client-reported receipt of care. There was an increase in assessment for all risks combined following the intervention (18 to 29 %; OR 3.55, p = 0.002: n = 805 at baseline, 982 at follow-up). No significant change in assessment, advice or referral for each individual risk was found. The intervention had a limited effect on increasing the provision of preventive care. Further research is required to determine how to increase the provision of preventive care in community mental health services. Australian and New Zealand Clinical Trials Registry ACTRN12613000693729