NLAAS II: Unraveling Differences for Clinical Services

NLAAS II：揭示临床服务的差异

• 批准号: 7241577
• 负责人: MARGARITA ALEGRIA
• 金额: $ 59.27万
• 依托单位: CAMBRIDGE HEALTH ALLIANCE
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-02-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7241577
• 关键词: Accounting; Address; Appendix; Area; Asian Americans; Asians; Attention; Clinical Services; Communities; Community Mental Health Services; Comorbidity; Data; Disease; Disease Clusterings; Epidemiologic Methods; Epidemiologic Studies; Epidemiology; Family; Geographic Distribution; Geographic Locations; Geography; Goals; Guidelines; Health Status; Health system; Healthcare Systems; Healthy People 2010; Hot Spot; Individual; Insurance; Knowledge; Latino; Link; Measurable; Measures; Mediating; Mental Health; Mental Health Services; Mental disorders; Methods; Minority; Minority Groups; National Institute of Mental Health; Performance; Policies; Policy Maker; Population; Population Heterogeneity; Positioning Attribute; Prevalence; Prevention; Provider; Psyche structure; Public Policy; Rate; Reporting; Request for Applications; Research Personnel; Resources; Risk; Role; Sampling; Science; Services; Solid; Solutions; Source; Strategic Planning; Surveys; Symptoms; System; TPO gene; Translating; base; contextual factors; health care service utilization; innovation; metropolitan; preference; racial and ethnic; racial and ethnic disparities; service utilization; socioeconomics

DESCRIPTION (provided by applicant): This continuation application requests three-years of support to investigate differences in the correlates of psychiatric illness and mental health service disparities among Asian Americans and Latinos as compared to non-Latino Whites. We will use recently collected data from the National Latino and Asian American Study (NLAAS), a national psychiatric epidemiologic study conducted to measure psychiatric disorders and mental health service usage in a representative sample of Asians and Latinos, and the National Comorbidity Study Replication (NCS-R). The combined NLAAS/NCS-R data are the best available to address critical questions regarding the level of service disparities, and the identification of service disparities "hot spots." In this resubmission, we apply an innovative conceptual framework to organize correlates for psychiatric illness, mental health service use and mental health service disparities, giving attention to health system and contextual factors in addition to traditional individual level factors. Specifically, our aims are to: (1) Use combined data from the NLAAS and the NCS-R to: compare prevalence of psychiatric disorders and mental health service use among Latinos, Asian, and non-Latino Whites; investigate hypotheses related to differences in the correlates of illness and mental health services; and assess bias in disorder prevalence and service use, (2) Apply the IOM definition of disparities to quantify disparities in services utilization and identify potential mechanisms underlying services disparities, and (3) Apply methods from spatial epidemiology to identify "hot spots" of mental health service disparities at the MSA level, and investigate health care system factors associated with high and low performing MSAs. This study will provide national baseline data on which to define the progress and measurable targets for mental health service disparity improvements for Latinos and Asian Americans as compared to non-Latino Whites. In addition, it will identify health system factors measured at the community and individual level that mediate disparities and can be targeted by policymakers. Finally, it will provide policymakers with information regarding where in the US mental health service disparities are unusually high. These findings can be used to target resources, develop coherent public policies, and inform guidelines aimed at making mental health prevention and treatment services more responsive and sensitive to the needs of ethnic/racial minorities.

描述(由申请人提供)：这份延续申请请求提供三年的支持，以调查亚裔美国人和拉美裔美国人与非拉美裔白人在精神疾病和精神健康服务差异方面的相关性。我们将使用最近从国家拉丁裔和亚裔美国人研究(NLAAS)收集的数据，这是一项全国性的精神流行病学研究，旨在衡量具有代表性的亚裔和拉丁裔样本中的精神障碍和精神健康服务使用情况，以及国家共病研究复制(NCS-R)。NLAAS/NCS-R的综合数据是解决有关服务差距水平和识别服务差距“热点”的关键问题的最佳选择。在这次重新提交中，我们应用了一个创新的概念框架来组织精神疾病、精神卫生服务利用和精神卫生服务差异的相关因素，除了传统的个人层面因素外，还考虑了卫生系统和背景因素。具体地说，我们的目标是：(1)使用NLAAS和NCS-R的联合数据：比较拉美裔、亚裔和非拉丁裔白人的精神障碍患病率和精神健康服务使用情况；调查与疾病和精神健康服务相关性差异相关的假设；(2)应用国际移民组织对差异的定义，以量化服务利用方面的差异，并找出服务差异潜在的机制；(3)应用空间流行病学的方法，确定精神卫生服务差异在MSA一级的“热点”，并调查与高绩效和低绩效MSA相关的保健系统因素。这项研究将提供国家基线数据，以确定与非拉美裔白人相比，拉美裔和亚裔美国人在改善精神卫生服务差距方面的进展和可衡量的目标。此外，它将确定在社区和个人一级衡量的卫生系统因素，这些因素调解差异，并可成为政策制定者的目标。最后，它将为政策制定者提供有关美国精神卫生服务差距异常高的信息。这些调查结果可用于确定资源的目标，制定连贯的公共政策，并为旨在使心理健康预防和治疗服务对族裔/种族少数群体的需求更具响应性和敏感性的指导方针提供参考。