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，极大地受到身体健康差距的影响，例如 癌症、肥胖症、糖尿病和心脏病。除了这些身体健康方面的差异，我们的证据 NIMH R21研究显示，太平洋岛民经历了相当大的心理健康差距，包括高水平 我们怀疑未经治疗的精神疾病可能导致太平洋岛民健康状况不佳和患病风险增加 慢性病(如癌症、肥胖)。 不幸的是，尽管许多太平洋岛民经历了高度的心理健康需求，但很少有人在场 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：智力低下 健康素养，高度的心理健康污名，以及对治疗知识的缺乏导致对 治疗和随后的耐药性。拟议的R34试点研究将通过创建和 试点测试对话故事：一种旨在促进太平洋岛民寻求治疗的新型干预措施 有文化根基的战略，以克服其主要的治疗障碍。在R21概念版的基础上构建 太平洋岛民模式-首选干预策略，Talking Story将结合以讲座为基础的内容 从当前的精神健康循证实践和创新的健康传播电影(称为 叙述)，描绘了太平洋岛民在与治疗有关的情况下的虚构故事。 为了建立对话故事，我们将设计授课内容和叙事电影的初始版本，并使用 太平洋岛民专家顾问委员会和一位专业电影制作人。然后我们将进行两位市民的 24个萨摩亚成年人、24个汤加成年人和12个洛杉矶治疗提供者的小组讨论 讨论和塑造我们的内容和电影对文化的契合和影响。使用来自这些面板的数据， 我们的内容将最终确定并合并到一份干预手册中，该手册将在随机情况下进行试点测试 对24名患有精神疾病的萨摩亚人和24名汤加人进行的等待名单对照试验，以获得有关 干预措施的可行性、可接受性和实用性；导致在以下情况下进行全面的随机对照试验 UP R01研究。研究结果将通过小册子和公众向太平洋岛民社区传播 论坛，并通过演讲和同行评议的手稿向科学界致敬。

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.