Engaging Pacific Islanders in Mental Health Treatment Services

摘要

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.