Mental Health Literacy Among Korean American Elders

描述（由申请人提供）：拟议的研究是为了回应对旨在帮助减少心理健康差异的研究的高度需求而编写的。这项调查的重点是一个增长最快、但研究不足、服务不足的少数族裔群体：韩裔美国老年人。基于我们之前的研究结果，即韩裔美国老年人有高水平的心理健康问题，但未充分利用心理健康服务，本研究将低心理健康素养概念化为服务未充分利用的主要原因和干预工作的中心焦点。总体目标是更好地了解目标人群的心理健康素养水平，并制定/测试一项教育干预措施。拟议的研究包括三个阶段：(1)采用混合方法收集数据，包括调查和焦点小组；(2)制定教育干预计划；(3)试点测试和评估。基于结构化问卷的调查数据将用于评估心理健康素养的水平，并确定心理健康素养的促进因素和障碍。为了对心理健康素养进行更深入的评估，还将使用焦点小组的数据。后一种讨论将与韩裔美国老年人及其家人、保健专业人员和宗教领袖进行。各种心理健康问题以及促进社区心理健康和服务利用的方法将成为各种观点的焦点。调查数据和焦点小组的结果将指导文化上适当和可接受的教育干预计划的发展。将以提高心理健康知识和积极改变对精神疾病和服务利用的态度为双重目标，编写韩文教育手册。我们还将采取以同伴为主导的教育策略，培训非专业的同伴领袖来提供教育课程。会议不仅包括小册子，还包括同伴教育和小组讨论。以同伴为基础的方法可以更敏感地关注少数民族社区的独特特征，在这些社区中，非正式领导人发挥着重要作用。在第三阶段，也就是最后一个阶段，将进行三种随机条件（对照、普通宣传册和同伴引导教育）的实验，以探索教育宣传册和同伴引导教育策略的有效性。我们假设：1)与对照组相比，接受治疗组（普通手册和同伴引导教育）的人对抑郁症的认识会增加，对精神疾病和服务使用的态度也会发生积极变化；2)同伴引导教育比只接受小册子的方法更有效。试点测试和评估将作为评估干预效果大小和方案在后续项目中实施可行性的重要手段。我们还希望利用我们的发现制定一项适用于其他少数民族群体的协议。

DESCRIPTION (provided by applicant): The proposed study is written in response to the heightened need for research designed to help reduce mental health disparities. The investigation focuses on one of the fastest growing but understudied and underserved ethnic minority groups: Korean American elders. Building upon our previous findings that Korean American older adults have high levels of mental health problems yet underutilize mental health services, the proposed study conceptualizes low mental health literacy as a major reason for service underutilization and a central focus of intervention efforts. The overall goals are to better understand the levels of mental health literacy manifest in the target population and to develop/test an educational intervention. The proposed study includes three phases: (1) data collection with a mixed methodology including a survey and focus groups; (2) development of an educational intervention program, and (3) pilot testing and evaluation. Survey data drawing on structured questionnaires will be used to assess the level of mental health literacy and to determine facilitators and barriers of mental health literacy. In order to provide a more in-depth assessment of mental health literacy, data from focus groups will also be used. The latter discussions will be conducted with Korean American older adults, their family members, health care professionals, and religious leaders. Various mental health issues and ways to promote community mental health and service utilization will serve as focal points for diverse perspectives. Findings from the survey data and focus groups will guide the development of a culturally appropriate and acceptable educational intervention program. An educational brochure in Korean will be written with the twin goals of increasing mental health literacy and making positive changes in attitudes toward mental disorders and service utilization. We will also adopt a peer-led education strategy where lay peer leaders are trained to deliver an educational session. The session includes not only the brochure but also peer-education and group discussion. The peer-based approach allows greater sensitivity to the unique characteristics of ethnic minority communities, where informal leaders play a significant role. During the third and final phase, an experiment with three randomized conditions (control, general brochure, and peer-led education) will be conducted to explore the effectiveness of the educational brochure and peer-led education strategy. We hypothesize that 1) those in the treatment groups (general brochure and peer-led education) would show increased knowledge of depression and positive changes in attitudes toward mental illness and service use compared to those in the control group, and 2) peer-led education would be more effective than the brochure-only approach. Pilot testing and evaluation will serve as an important means to assess effect size of intervention and feasibility of the program for implementation in a subsequent project. We also hope to use our findings to develop a protocol for application to other ethnic minority groups. Public Health Relevance: Building upon previous findings that Korean American older adults have high levels of mental health problems yet underutilize mental health services, the proposed study conceptualizes low mental health literacy as a major reason for service underutilization and a central focus of intervention efforts. The overall goals of the study are (1) to better understand the levels of mental health literacy manifest in the target population and (2) to develop/test an educational intervention.