Feasibility of an Early Detection Program for Early Psychosis on a College Campus

大学校园早期精神病早期检测计划的可行性

• 批准号: 10164864
• 负责人: ANNETTE S CRISANTI
• 金额: $ 22.53万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10164864
• 关键词: Address; Age; Appearance; Caring; Clinical; Clinical Services; Clinical assessments; Communities; Counseling; Data; Early Diagnosis; Effectiveness; Elements; Ethnic Origin; Excision; Goals; Health Services Accessibility; Health system; Hospitalization; Individual; Intake; Intervention; Knowledge; Link; Literature; Location; Methods; Mission; National Institute of Mental Health; New Mexico; Outcome; Pathway interactions; Population; Process; Psychiatry; Psychoses; Public Health; Questionnaires; Race; Recovery; Reporting; Research; Risk; Services; Source; Students; Suicide; Surface; Symptoms; Target Populations; Testing; Time; Training; United States; Universities; adverse outcome; barrier to care; base; care systems; clinical care; college; cost; design; ethnic diversity; first episode psychosis; functional outcomes; help-seeking behavior; high risk; high risk population; improved; innovation; literacy; medical specialties; meetings; person centered; programs; psychotic symptoms; racial diversity; response; scale up; screening; shared decision making; success; suicide rate; support tools; university student; uptake; young adult

PROJECT SUMMARY Although evidence on community-based early detection (ED) programs aimed to reduce prolonged durations of untreated psychosis (DUP) is large and growing, very little is known about the effectiveness of ED services on college campuses in the United States. This gap in the literature is problematic because, with the first symptoms of psychosis being most likely to surface among college age young adults, college campuses are hubs for individuals at an age of increased risk of first episode psychosis (FEP). The long-term goal of our program of research is to improve clinical and functional outcomes among college students with early stages of psychosis by reducing DUP. The objective of our proposed study is to determine the feasibility of an ED program that aims to: (i) identify college students at clinical high risk (CHR) of psychosis or with FEP, and (ii) efficiently link them to coordinated specialty care (CSC) services for a 2nd stage screen, a clinical assessment, and appropriate treatment. We will also provide preliminary estimates of effectiveness with respect to the intervention. Our ED program will include two organizational level changes. First, we will implement universal screening (i.e., the Prodromal Questionnaire Brief) for psychosis among college students who are seeking help at a college counseling center. Second, we will implement a collaborative, person-centered, and rapid referral process (<2 weeks) to CSC. Person-centered elements of the referral process include shared-decision making and a warm handoff. Our central hypotheses are that our multi- level ED program will be feasible, and that preliminary data will show an increase in the number of referrals of college students to CSC. Furthermore, DUP will be shorter and there will be fewer steps and perceived barriers to care among college students referred to CSC through our ED program compared to college students who present to CSC from other referral sources. Our hypotheses will be tested by pursing two specific aims: 1) Identify whether (i) case identification, and (ii) referral-related barriers to CSC are important targets for ED programs on college campuses; and 2) Evaluate the feasibility of our ED program from the perspectives of various stakeholders. The proposed study is significant because it will produce a vertical step in the DUP scientific field by increasing knowledge on the 1) mechanisms of change for DUP among college students, and 2) feasibility of an ED program embedded within a college counseling center in partnership with a CSC program. The study will also elucidate barriers to CSC among an ethnic and racial diverse young adult population. Ultimately, such knowledge has the potential of offering new opportunities to reduce DUP among young adults nationwide.

项目摘要 虽然基于社区的早期发现（艾德）计划旨在减少 长期未治疗的精神病（DUP）是一个大的和不断增长的，很少有人知道 关于美国大学校园里艾德服务的有效性。中的这一空白 文献是有问题的，因为精神病的最初症状最有可能 在大学年龄的年轻人中，大学校园是一个年龄段的个人的中心。 精神病首次发作（FEP）的风险增加。我们计划的长期目标是 研究是为了改善早期患有糖尿病的大学生的临床和功能结果， 通过减少DUP来治疗精神病。我们建议的研究目的是确定 一个艾德计划的可行性，旨在：（一）确定大学生在临床高风险（ESTA） 精神病或FEP，以及（ii）有效地将其与协调专业护理（CSC）联系起来 第二阶段筛查、临床评估和适当治疗的服务。我们还将 提供干预措施有效性的初步估计。我们的艾德计划 将包括两个组织层面的变化。首先，我们将实施普遍筛查（即， 大学生精神病求助者前驱症状问卷调查 在大学咨询中心第二，我们将实施以人为本的合作， 快速转介流程（<2周）到CSC。转介过程中以人为本的要素 包括共享决策和热切换。我们的核心假设是，我们的多- 水平艾德规划将是可行的，初步数据将显示， 大学生转介到CSC。此外，DUP将更短， 通过我们的艾德转介到CSC的大学生中的护理步骤和感知障碍 计划相比，大学生谁目前CSC从其他转介来源。我们 假设将通过追求两个具体目标进行测试：1）确定是否（i）病例识别， （ii）与家庭相关的CSC障碍是大学艾德教育计划的重要目标 2）从不同的角度评估我们的艾德计划的可行性 持份者拟议的研究是重要的，因为它将产生一个垂直步骤， DUP科学领域，通过增加对1）DUP变化机制的了解， 大学生，和2）一个艾德计划嵌入在大学咨询的可行性 与CSC计划合作。该研究还将阐明CSC的障碍， 一个民族和种族多样化的年轻成年人口。最终，这些知识 为减少全国年轻人中的DUP提供新机会的潜力。