A Randomized Trial of Family to Family Education

家庭与家庭教育的随机试验

• 批准号: 7472451
• 负责人: LISA B. DIXON
• 金额: $ 45.75万
• 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 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7472451
• 关键词: Accounting; Adherence; Adult; Anger; Anxiety; Area; Behavior; Caregivers; Caring; Characteristics; Class; Clinical; Clinical Services; Collaborations; Communication; Communities; Condition; Consent; Coping Behavior; County; Crisis Intervention; Data; Diagnostic Services; Distress; Education; Educational Curriculum; Effectiveness; Elements; Emotional; Emotions; Enrollment; Equilibrium; Evaluation; Family; Family member; Feeling; Financial Support; Fright; Goals; Grief reaction; Health system; Healthcare Systems; Individual; Knowledge; Length; Life; Love; Maryland; Measures; Mental Depression; Mental Health; Mental disorders; Mentally Ill Persons; Modeling; Nature; Numbers; Outcome; Outcome Study; Participant; Patient Self-Report; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pilot Projects; Problem Solving; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Rate; Recovery; Recruitment Activity; Relapse; Relative (related person); Reporting; Research; Research Personnel; Resources; Role; Schedule; Schizoaffective Disorders; Schizophrenia; Scientific Evaluation; Services; Shock; Source; Stress; Stress and Coping; Structure; Study Subject; Symptoms; System; Testing; Time; Training; Trauma recovery; Week; Work; authority; base; burden of illness; caregiving; coping; cost; displeasure; emotional experience; experience; formycin triphosphate; improved; medication compliance; member; optimism; peer; programs; psychoeducation; psychological distress; response; self help; service utilization; severe mental illness; skills; stressor; theories; trial comparing; volunteer

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有据可查。在履行提供照顾的角色时，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，基于同伴和社区的方案出现了。这些方案包括自助、赋权、创伤康复、压力和应对理论以及互助模式等要素，主要侧重于帮助家庭成员，而不是改善消费者的结果。家庭自助计划得到广泛传播，在参与者中非常受欢迎，并获得州和市心理健康当局的适度财政支持。但这种传播之前并没有科学证据表明他们实现了自己的目标。我们的项目正是要弥补这种知识上的差距。到目前为止，最常见的这类方案是全国精神病患者家庭对家庭教育方案联盟（通常缩写为FTP）：一个为期12周的课程，有高度结构化的标准化课程，由受过训练的家庭成员制定和进行。它提供有关精神疾病的教育，情感和实际支持，以及解决问题和沟通技巧。我们与FTP创建者Joyce Burland合作，进行了两项独立的试点研究，证明FTP可以有效减少参与者自我报告的主观负担和抑郁，并增加他们的权力。我们现在提出一个随机试验，比较完成三个月FTP课程的个人和使用通常社区资源的个人。在我们评估家庭成员结果的同时，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，FTP的好处将在FTP计划完成后6个月保留。其次，我们假设FTP参与者的家庭中的消费者将有更好的结果。将在四个马里兰州县的28个不同班级招募总共392名家庭成员参与者，在考虑研究损耗后，每个研究条件下产生约150人。在创建FTP项目的随机试验评估过程中，我们不得不在一些问题上平衡科学严谨性与现实生活中的实际和伦理问题，从而产生了某些方法上的限制。尽管如此，这项研究所代表的学术/消费者伙伴关系对于建立一个既由消费者和家庭驱动，又基于科学证据的医疗保健系统至关重要。

项目成果

Differences between parents of young versus adult children seeking to participate in family-to-family psychoeducation.

寻求参与家庭间心理教育的年幼儿童与成年儿童的父母之间的差异。

• DOI: 10.1176/appi.ps.201300045
• 发表时间: 2014
• 期刊: Psychiatric services (Washington, D.C.)
• 作者: Schiffman,Jason;Kline,Emily;Reeves,Gloria;Jones,Amanda;Medoff,Deborah;Lucksted,Alicia;Fang,LiJuan;Dixon,LisaB
• 通讯作者: Dixon,LisaB

The Relationship Between the Perceived Risk of Harm by a Family Member with Mental Illness and the Family Experience.

• DOI: 10.1007/s10597-014-9799-3
• 发表时间: 2015-10
• 期刊: Community mental health journal
• 影响因子: 2.7
• 作者: Katz J;Medoff D;Fang LJ;Dixon LB
• 通讯作者: Dixon LB

Sustained outcomes of a peer-taught family education program on mental illness.

• DOI: 10.1111/j.1600-0447.2012.01901.x
• 发表时间: 2013-04
• 期刊: Acta psychiatrica Scandinavica
• 影响因子: 6.7
• 作者: Lucksted A;Medoff D;Burland J;Stewart B;Fang LJ;Brown C;Jones A;Lehman A;Dixon LB
• 通讯作者: Dixon LB

Race-related differences in the experiences of family members of persons with mental illness participating in the NAMI Family to Family Education Program.

参与 NAMI 家庭教育计划的精神疾病患者家庭成员的经历存在与种族相关的差异。

• DOI: 10.1007/s10464-014-9674-y
• 发表时间: 2014
• 期刊: American journal of community psychology
• 影响因子: 3.1
• 作者: Smith,MelissaEdmondson;Lindsey,MichaelA;Williams,CrystalD;Medoff,DeborahR;Lucksted,Alicia;Fang,LiJuan;Schiffman,Jason;Lewis-Fernández,Roberto;Dixon,LisaB
• 通讯作者: Dixon,LisaB