A Randomized Trial of Family to Family Education

家庭与家庭教育的随机试验

• 批准号: 7124695
• 负责人: LISA B. DIXON
• 金额: $ 58.16万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-23 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7124695
• 关键词: behavioral /social science research tag; caregivers; clinical research; clinical trials; coping; curriculum; depression; education evaluation /planning; educational resource design /development; family structure /dynamics; health care model; human subject; interview; longitudinal human study; mental health education; outcomes research; problem solving; psychological stressor; quality of life; questionnaires; self help; social support network

DESCRIPTION (provided by applicant): The important roles of families in the lives of adults with serious mental illnesses are well documented. In fulfilling care-giving roles, families are typical of people coping with stressful circumstances in that they need information and support. When clinical services failed to meet the needs of families, peer- and community-based programs emerged. These programs incorporate elements of self-help, empowerment, trauma recovery, stress and coping theories, as well as mutual assistance models and are primarily focused on helping family members, not improving consumer outcomes. Family self-help programs are widely disseminated, are very popular among their participants and receive modest financial support from state and municipal mental health authorities. But this dissemination was not preceded by scientific evidence that they achieve their goals. It is this gap in knowledge that our project is proposing to remedy. By far the most common such program is the National Alliance for the Mentally Ill's Family-to-Family Education Program (often abbreviated FTP): a 12-week class with a highly-structured standardized curriculum, developed and conducted by trained family members. It provides education about mental illness, emotional and practical support, and problem solving and communication skills. In collaboration with FTP creator, Joyce Burland, we have conducted two independent pilot studies demonstrating that FTP is effective for reducing participants' self-reported subjective burden and depression and increasing their empowerment. We now propose a randomized trial comparing individuals who completed a three-month FTP class to individuals referred to the usual community resources. At the same time that we are evaluating family member outcomes, this study provides an opportunity to evaluate the potential benefit that FTP has for consumers. Guided by a stress-coping framework, we hypothesize that FTP participants will have increased problem- and emotion-focused coping activities, reduced depression, distress, and subjective illness burden and that FTP benefits will be retained six months after FTP program completion. Secondarily, we hypothesize that consumers in families of FTP participants will have improved outcomes. A total of 392 family member participants will be recruited in four Maryland counties over 28 different classes, producing approximately 150 persons in each study condition after accounting for study attrition. In the course of creating a randomized trial evaluation of the FTP program, we have had to balance scientific rigor with real-life practical and ethical concerns on a number of issues, creating certain methodological limitations. Nevertheless, the academic/consumer partnership represented by this study is critical to creating a health care system that is both consumer and family driven, and also based on scientific evidence.

描述（由申请人提供）：家庭在患有严重精神疾病的成年人生活中的重要作用已被充分记录。在履行照顾角色时，家庭是典型的应对压力环境的人，因为他们需要信息和支持。当临床服务不能满足家庭的需要时，同伴和社区项目出现了。这些项目结合了自助、授权、创伤恢复、压力和应对理论以及互助模式的元素，主要侧重于帮助家庭成员，而不是改善消费者的结果。家庭自助计划广为传播，在参与者中非常受欢迎，并得到州和市精神卫生当局的适度财政支持。但是，在这种传播之前，并没有科学证据表明它们实现了目标。我们的项目正是要弥补这一知识上的差距。到目前为止，最常见的此类项目是全国精神病患者家庭对家庭教育项目联盟（简称FTP）：一个为期12周的课程，具有高度结构化的标准化课程，由训练有素的家庭成员开发和实施。它提供关于精神疾病、情感和实际支持、解决问题和沟通技巧的教育。在与FTP创建者Joyce Burland的合作下，我们进行了两项独立的试点研究，证明FTP在减少参与者自我报告的主观负担和抑郁以及增加他们的赋权方面是有效的。我们现在建议进行一项随机试验，比较完成三个月FTP课程的个体和参考常规社区资源的个体。与此同时，我们正在评估家庭成员的结果，这项研究提供了一个机会来评估FTP对消费者的潜在好处。在压力应对框架的指导下，我们假设FTP参与者将增加以问题和情绪为中心的应对活动，减少抑郁、痛苦和主观疾病负担，并且FTP项目完成后六个月仍将保留FTP的益处。其次，我们假设FTP参与者家庭中的消费者会有更好的结果。共有392名家庭成员参与者将被招募到马里兰州的四个县，在28个不同的班级中，在计算研究人员流失后，每种研究条件下大约有150人。在创建FTP项目的随机试验评估过程中，我们必须在许多问题上平衡科学严谨性与现实生活中的实践和伦理问题，从而产生某些方法上的局限性。尽管如此，本研究所代表的学术/消费者伙伴关系对于创建一个消费者和家庭驱动的医疗保健系统至关重要，同时也以科学证据为基础。