1/2-Integration of Illness Management and Recovery Within ACT

1/2-ACT 内疾病管理和康复的整合

• 批准号: 8286209
• 负责人: GARY A MORSE
• 金额: $ 21.56万
• 依托单位: PLACES FOR PEOPLE, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-07 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8286209
• 关键词: Adult; Advisory Committees; Caring; Clinical; Clinical Trials; Clinical Trials Design; Combined Modality Therapy; Committee Members; Communities; Consensus; Data; Data Collection; Data Reporting; Decision Making; Development; Doctor of Philosophy; Effectiveness; Elements; Evaluation; Event; Evidence based practice; Feedback; Goals; Grant; Hospitalization; Housing; Individual; Institutes; Intervention; Interviewer; Lead; Learning; Learning Disabilities; Life; Link; Manuals; Mental Health; Missouri; Modeling; Modification; Outcome; Participant; Persons; Pilot Projects; Process; Protocols documentation; Provider; Randomized; Randomized Clinical Trials; Recovery; Recovery of Function; Relapse; Reporting; Research; Research Project Grants; Research Training; Role; Sampling; Services; Site; Specific qualifier value; Staging; Symptoms; System; Teleconferences; Testing; Training; Treatment Effectiveness; Treatment Protocols; Voting; Washington; Work; authority; community based treatment; community living; cost effectiveness; design; experience; functional disability; improved; improved functioning; innovation; meetings; member; novel; prevent; programs; psychiatric disability; psychosocial; research and development; severe mental illness; success; treatment effect; treatment program

The goals of our multi-site, linked R34 proposals are to develop and evaluate the feasibility of a novel psychosocial approach for improving the mental health of people with severe mental illness while obtaining preliminary pilot data needed to plan a subsequent R01 research application to further evaluate this intervention. Specifically, we plan to adapt and pilot an approach for integrating two evidence-based practices for adults with serious mental illness: Illness Management and Recovery (IMR) and Assertive Community Treatment (ACT). This R34 research project will accomplish three specific aims: (1) develop, adapt, and standardize the treatment protocol for integrating IMR into ACT teams; (2) assess the implementation feasibility and acceptability of the IMR+ACT intervention in a small, open clinical trial; and (3) conduct a preliminary outcome and process evaluation using a pilot randomized clinical trial (RCT) design, with randomization occurring at the ACT team level. We hypothesize that the protocol for combining IMR+ACT will be feasible to implement and acceptable to consumers and providers. The integrated IMR+ACT program has the potential to reduce persistent symptoms, enhance functioning, and facilitate the recovery of people with severe mental illness who are receiving ACT services. The research and development activities will be conducted in three stages. In Stage 1 we will expand our pre-application pilot activities to further develop, adapt, and refine the IMR+ACT treatment protocol. The new protocol will include a new treatment manual, training materials, and a fidelity scale, all of which will specify the adaptation and integration of IMR within ACT. During Stage 2, we will conduct a small open trial of IMR+ACT in order to collect data on the feasibility of implementing the program, its acceptability, and the fidelity of ACT staff to the model. In Stage 3, we will conduct an outcome and process evaluation of the IMR+ACT intervention using an RCT design. Specifically, we will randomize eight teams to implement either the IMR+ACT program or continue to provide ACT Only (four teams per condition) in two states, and assess outcomes across a battery of clinical, functional, and recovery variables in a total of 96 consumers (12 per ACT team). The findings will yield important information about the feasibility of randomizing ACT teams to provide IMR or not, estimates of within team variances, and preliminary data on the clinical impact of adding IMR to ACT services, which will inform the planning of a larger-scale R01 study of IMR+ACT effectiveness.

我们的多站点，链接R34提案的目标是开发和评估一种新的心理社会方法的可行性，以改善严重精神疾病患者的心理健康，同时获得计划后续R 01研究应用所需的初步试点数据，以进一步评估这种干预措施。具体来说，我们计划调整和试点一种方法，将两种基于证据的做法整合为患有严重精神疾病的成年人：疾病管理和恢复（IMR）和自信的社区治疗（ACT）。该研究项目将实现三个具体目标：（1）开发、调整和标准化IMR与ACT团队整合的治疗方案;（2）在小型开放临床试验中评估IMR+ACT干预的实施可行性和可接受性;以及（3）使用先导随机临床试验（RCT）设计进行初步结果和过程评价，随机化发生在ACT团队水平。我们假设，IMR+ACT相结合的协议将是可行的，消费者和供应商可以接受。综合IMR+ACT计划有可能减少持续症状，增强功能，并促进接受ACT服务的严重精神疾病患者的康复。研究和开发活动将分三个阶段进行。在第一阶段，我们将扩大我们的申请前试点活动，以进一步开发，调整和完善IMR+ACT治疗方案。新方案将包括新的治疗手册、培训材料和保真度量表，所有这些都将详细说明ACT中IMR的适应和整合。在第二阶段，我们将进行一项IMR+ACT的小型开放试验，以收集有关实施该计划的可行性、可接受性以及ACT工作人员对该模型的忠诚度的数据。在第3阶段，我们将使用RCT设计对IMR+ACT干预进行结果和过程评估。具体来说，我们将随机分配8个团队，在两个州实施IMR+ACT计划或继续提供ACT（每个条件4个团队），并在总共96名消费者（每个ACT团队12名）中评估一系列临床，功能和恢复变量的结果。这些发现将产生关于随机分配ACT团队提供IMR或不提供IMR的可行性的重要信息，团队内方差的估计，以及关于将IMR添加到ACT服务的临床影响的初步数据，这将为IMR+ACT有效性的更大规模R 01研究的规划提供信息。