Recovery Roadmap: Person-Centered Care Planning

描述（由申请人提供）：服务脱离是目前美国精神卫生系统面临的最普遍和最具挑战性的问题之一。康复中的人将他们脱离护理归咎于与护理提供者的关系不佳，包括没有机会在自己的治疗中做出决定和合作。作为回应，精神卫生系统正朝着更广泛地使用以人为中心的护理计划（PCCP）的方向发展，这是一种基于证据的干预措施，旨在最大限度地提高消费者对治疗过程的选择和所有权。虽然PCCP已经被许多人接受，但这种模式并没有被广泛传播，许多精神疾病患者在参与自己的治疗计划时仍然感到自我效能低下。此外，提供者（如精神科医生、社区精神卫生工作者、同伴专家等）往往难以确定将PCCP原则纳入其日常实践的具体方法。社会创新中心（C4）和耶鲁大学康复和社区健康项目（PRCH）提议将PRCH的现场测试的PCCP内容改编为恢复路线图：以人为中心的护理计划的协作工具，这是一个高度互动的基于网络的工具，支持消费者和提供者以人为中心的康复计划的协作过程。该项目的具体目标是：1)创建恢复路线图工具包；2)确定“恢复路线图”的可行性，以改善消费者的心理卫生保健；3)探索产品的商业潜力。恢复路线图的核心部分是一个创新的基于网络的工具，它通过一系列引人入胜的多媒体、同行引导的练习来指导恢复中的人们制定个人恢复计划，以确定优先事项和生活目标。一个补充组件通过模拟PCCP交互的交互式、基于案例的视频片段来教育提供者并支持PCCP的实施。这两种工具——可以在电脑、移动设备和平板电脑上访问——协同工作，支持整体的消费者-提供者关系，并创建一个协作的、以人为本的护理计划流程。C4将进行第一阶段研究，以确定进行更大规模的相对有效性试验的可行性。我们将在德克萨斯州的两家社区精神卫生中心通过方便样本测试此工具，这些样本将随机分为两种情况：1)仅使用恢复路线图工具（n=15家提供者），以及2)在使用恢复路线图工具之前进行标准的现场PCCP培训（n=15家提供者），每个提供者根据其案件负载招募两名消费者来试用恢复路线图工具（n=60名消费者）。数据来源将包括三个月前、三个月后和三个月的跟踪调查、焦点小组讨论和关键信息者访谈，以捕捉态度、信念、知识、自我效能、对消费者-供应商关系的看法和市场能力。数据将使我们能够磨练产品可用性、研究设计和假设，以便在第二阶段的研究中进行测试。最后，我们将进行市场分析，并制定初步的营销和定价策略。

DESCRIPTION (provided by applicant): Service disengagement is one of the most pervasive and challenging problems currently facing America's mental health system. People in recovery have attributed their disengagement from care to having poor alliances with care providers, including experiences of not being offered the opportunity to make decisions and collaborate in their own treatment. In response, the mental health system is moving toward wider use of Person-Centered Care Planning (PCCP), an evidence-based intervention designed to maximize consumer choice and ownership of the treatment process. While PCCP has been embraced by many, the model has not been widely disseminated, and many people with mental illnesses continue to experience low self-efficacy in participating in their own treatment planning. Additionally, providers (e.g., psychiatrists, community mental health workers, peer specialists, etc.) often struggle to identify concrete ways to incorporate PCCP principles into their daily practice. The Center for Social Innovation (C4) and Yale University's Program for Recovery and Community Health (PRCH) propose to adapt PRCH's field-tested PCCP content into Recovery Roadmap: A Collaborative Tool for Person-Centered Care Planning, a highly interactive web-based tool to support a collaborative process of person-centered recovery planning for consumers and providers. The specific aims of this project are to: 1) create the Recovery Roadmap toolkit; 2) determine the feasibility of the Recovery Roadmap to improve mental health care for consumers; and 3) explore the product's commercial potential. The central component of the Recovery Roadmap is an innovative web-based tool that guides people in recovery to create an individual recovery plan through a series of engaging multimedia, peer-led exercises to identify priorities and life goals. A complementary component educates providers and supports implementation of PCCP through interactive, case-based video vignettes that simulate PCCP interactions. The two tools - which can be accessed on computers, mobile devices, and tablets - work in tandem to support the overall consumer-provider relationship and create a collaborative, person-centered care planning process. C4 will conduct a phase one study to determine the feasibility of conducting a larger relative effectiveness trial. We will pilt this tool through a convenience sample in two community mental health centers in Texas, which will be randomized into two conditions: 1) Recovery Roadmap tool only (n=15 providers), and 2) Recovery Roadmap tool preceded by standard on-site PCCP training (n=15 providers), with each provider recruiting two consumers on their caseload to pilot the Recovery Roadmap tool (n=60 consumers). Data sources will include pre-, post-, and three-month follow-up surveys, focus group discussions, and key informant interviews to capture attitudes, beliefs, knowledge, self-efficacy, perceptions of the consumer-provider relationship, and marketability. Data will allow us to hone product usability, study design, and hypotheses to be tested in a phase two study. Finally, we will conduct a market analysis and develop preliminary marketing and pricing strategies.