Engaging Pacific Islanders in Mental Health Treatment Services

摘要 太平洋岛民是一个脆弱的种族人口，受到身体健康差异的极大影响， 癌症、肥胖症、糖尿病和心脏病。除了这些身体健康的差异，我们的证据表明， NIMH R21研究显示，太平洋岛民经历了相当大的心理健康差异，包括高水平 未经治疗的精神疾病，我们怀疑可能导致太平洋岛民的健康状况不佳， 慢性疾病（例如，癌症、肥胖症）。 不幸的是，尽管许多太平洋岛民经历了高水平的心理健康需求， 接受治疗这似乎是由于我们的R21中确定的以下主要治疗障碍： 健康素养，高度的心理健康耻辱感，以及对治疗知识的缺乏，导致对 治疗和随后的抵抗。拟议的R34试点研究将通过创建和 试点测试Talking Story：一项旨在促进太平洋岛民寻求治疗的新干预措施， 以文化为基础的战略，以克服他们的主要治疗障碍。基于R21概念 作为太平洋岛民偏爱的干预策略的典范，Talking Story将联合收割机结合基于讲座的内容 从目前的心理健康循证实践与创新的健康沟通电影（称为 描述治疗相关场景中太平洋岛民的虚构故事。 为了建立Talking Story，我们将设计讲座内容和叙事电影的初始版本， 太平洋岛民专家和专业电影制片人的咨询理事会。然后我们将进行两个公民的 小组将24名萨摩亚成年人、24名汤加成年人和12名治疗提供者聚集在洛杉矶 县讨论和塑造我们的内容和电影的文化适应和影响。利用这些小组的数据， 我们的内容将最终确定，并结合成一个干预手册，将在一个随机试点测试。 一项有24名萨摩亚人和24名汤加人患有精神疾病的等待名单对照试验， 干预的可行性，可接受性和实用性;导致全面的随机对照试验，在以下- 上R 01研究。研究结果将通过小册子向太平洋岛民社区传播， 论坛，并通过介绍和同行评审的手稿向科学界。

Abstract Pacific Islanders are a vulnerable racial population that is greatly affected by physical health disparities such as cancer, obesity, diabetes, and heart disease. In addition to these physical health disparities, evidence from our NIMH R21 research reveals Pacific Islanders experience sizable mental health disparities including high levels of untreated mental illness that we suspect may contribute to Pacific Islanders’ poor health and elevated risk of chronic disease (e.g., cancer, obesity). Unfortunately, although many Pacific Islanders experience high levels of mental health need, very few present for treatment. This appears to be due to the following major treatment barriers identified in our R21: low mental health literacy, high mental health stigma, and poor knowledge of treatment leading to misperceptions of treatment and subsequent resistance. The proposed R34 pilot study will address this problem by creating and pilot testing Talking Story: a novel intervention designed to promote Pacific Islander treatment seeking by using culturally grounded strategies to overcome their major treatment barriers. Building on our R21 conceptual model of Pacific Islander-preferred intervention strategies, Talking Story will combine lecture-based content from current mental health evidence-based practices with innovative health communication films (called narratives) that depict fictional stories of Pacific Islanders in treatment-related scenarios. To build Talking Story, we will design the initial versions of the lecture content and narrative films with an advisory council of Pacific Islander experts and a professional filmmaker. We will then conduct 2 citizens’ panels to bring together 24 Samoan adults, 24 Tongan adults, and 12 treatment providers in Los Angeles County to discuss and shape our content and films for cultural fit and impact. Using the data from these panels, our content will be finalized and combined into an intervention manual that will be pilot tested in a randomized wait-list controlled trial with 24 Samoans and 24 Tongans with mental illness to gain information about the intervention’s feasibility, acceptability, and utility; leading to full-scale randomized controlled testing in a follow- up R01 study. Study findings will be disseminated to the Pacific Islander community via brochures and public forums, and to the scientific community via presentations and peer-reviewed manuscripts.