ASSESSING CONSUMER-OPERATED SERVICES

描述（申请人摘要）：长期、持续的精神疾病是 通常与贫困和失业有关。尽管MH取得了进展， 治疗方法，完全康复的前景仍然很差， 有精神残疾的成年人。消费者运营的服务， 已经推广了专业治疗的替代品或替代品， 参与和授权具有严重精神疾病的个人的潜在益处 疾病。有效性研究，使用实验设计，还没有得到 完了考虑到被标记为“消费者操作”的程序的异质性， 他认为，在一个模型被完全描述之前，这样的研究是没有用的， 建立了标准，并验证了可用于衡量 这种治疗模式。此R24应用程序建议描述最常见的 消费者经营的服务模式-拜访中心（CDI），建立 忠诚度标准，并将其付诸实施和验证。我们将收集 密歇根州所有CDIs的数据（n=29）-采访消费者用户和关键 信息提供者，收集定性观察措施，并检查 记录和其他文件。同样的数据将收集在 结构上可比较的方案（会所），与地理位置相匹配。 通过这个R24，我们将有一个丰富的操作说明， 消费者经营的上门服务中心，以及会所，利用标准 从文献和消费者专家。我们将分析CDIs如何不同 从会所，根据这些设置的大量用户。的 R24将制定由一组消费者专家认证的保真度标准 并通过使用服务的消费者的报告进行验证， 报告的水平和判别效度。此外，我们将实施 这些标准通过更容易获得的数据（记录、文档和密钥） 因此，未来关于CDIs的研究可以用更少的 资源密集型的方法，而不是采访中心用户。当我们完成 在R24中，我们将设计多中心（R 01）有效性研究， 消费者操作的下拉式，使用实验设计。保真度测量 从这个R24和程序手册产生的将是不可分割的R 01， 对交付的模型提供一致的质量评估，以及 作为过程测量，用作调节变量，以解释差异 CDI用户的中期和长期行为结果。初步 提出了未来效能研究的概念模型。发起 这项研究通过UM中心研究贫困，风险和心理 健康将使既定的研究者（莫布雷）与新的 教师（霍尔特）和高级教师（加文），并涉及其他年轻的 研究人员（博士后和博士生）对精神卫生服务 研究主题，将作为进一步重大研究的基础， 消费主义和复苏。这些消费者运营服务的研究将 受益于我们在贫困中心的同事的专业知识， 衡量人力资本。R24将使我们能够与 全国各地的消费者团体和消费者研究人员， 精神病学和其他相关领域在UM，和其他国家的网站， MH服务研究。

DESCRIPTION (Applicant's abstract): Long-term, persistent mental illness is typically associated with poverty and unemployment. Despite advances in MH treatment methods, prospects for full rehabilitation remain poor for most adults with psychiatric disabilities. Consumer-operated services as alternatives or adjuncts to professional treatments have been promoted for potential benefits in engaging and empowering individuals with serious mental illnesses. Effectiveness research, using experimental designs, has yet to be done. Given the heterogeneity of programs labeled "consumer-operated," it is argued that such research will not be useful until a model is fully described, criteria established, and validated methods available to measure fidelity to this treatment model. This R24 application proposes to describe the most common model of consumer-operated services - the drop-in center (CDI), to establish fidelity criteria, and to operationalize and validate them. We will collect data on all the CDIs in Michigan (n=29)- interviewing consumer-users and key informants, collecting qualitative observational measures, and examining records and other documentation. The same data will be collected on structurally comparable programs (clubhouses), matched for geographic location. Through this R24, we will have a rich description of the operation of consumer-operated drop-in centers, as well as of clubhouses, utilizing criteria from the literature and consumer experts. We will analyze how the CDIs differ from clubhouses, according to a large number of users of these settings. The R24 will produce fidelity criteria, certified by a group of consumer experts and validated through reports of consumers using the services - in terms of levels reported and discriminant validity. Furthermore, we will operationalize these criteria through more readily available data (records, documents, and key informants) so that future research on CDIs can establish fidelity with less resource-intensive methods than interviewing center users. As we are completing this R24, we will design a multisite (R01) effectiveness study of consumer-operated drop-ins, using an experimental design. The fidelity measure from this R24 and the program manual produced will be integral to the R01, providing a consistent quality assessment of the model being delivered, as well as process measures for use as moderating variables to interpret differential intermediate and long-term behavioral outcomes for CDI users. A preliminary conceptual model for the future effectiveness study is presented. Initiating this research through the UM Center for Research on Poverty, Risk and Mental Health will enable an established investigator (Mowbray) to work with new faculty (Holter) and senior faculty (Garvin), and to involve other young investigators (post-doc and doctoral students) on a mental health services research topic that will serve as the basis for further significant studies on consumerism and recovery. These studies of consumer-operated services will benefit from the expertise of our colleagues at the poverty center ways to measure human capital. The R24 will enable us to develop relationships with consumer groups and consumer researchers around the country, colleagues in psychiatry and other related areas at UM, and other national sites undertaking MH services research.