CULTURAL RELEVANCE OF A CONTINUITY OF CARE MEASURE

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This two-year project will examine the cultural relevance of a measure of continuity of care in mental health services for ethnic minorities in the U.S. This measure is the first, detailed, standardized instrument designed to assess continuity of care for persons with serious mental illness. It is intended for use in studies of quality of care and other health services research. The measure is the product of a three-year program of systematic research, beginning with an ethnographic study to empirically derive relevant indicators of continuity, and proceeding through comprehensive processes of instrument construction, preliminary testing, field testing, and psychometric evaluation. Thus the proposed project targets a population that is doubly vulnerable: seriously mentally ill persons who belong to ethnic minority groups. Cultural relevance refers to the applicability and the importance of continuity indicators for ethnic minorities. The design of the proposed study combines qualitative and quantitative methodologies in a three-pronged approach to investigating cultural relevance. In Part 1, we will use open-ended interviewing and focus group discussions as the basis for identifying new domains and items that are relevant for ethnic minorities, but not part of the measure in its present form. In Part 2, we will rank the importance of new and existing domains and items for minority and white respondents, and compare the rankings across groups using simple statistical techniques. Part 3 calls for examining previously collected field test data for ethnic group differences on the measure's existing indicators of continuity of care.