Administrative Supplement for Peer-Delivered and Technology-Assisted Integrated Illness Management and Recovery

同行交付和技术辅助的综合疾病管理和康复的行政补充

基本信息

批准号：
10811292
负责人：
Karen L. Fortuna
金额：
$ 4万
依托单位：
DARTMOUTH-HITCHCOCK CLINIC
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-01 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10811292
关键词：
Activities of Daily Living Address Administrative Supplement Adoption Adult Affect Agreement Certification Chronic Chronic Disease Clinical Trials Communities Development Diagnosis Drops Effectiveness Enrollment Ensure Evidence based intervention Evidence based practice General Population Health Health Personnel Intervention Interview Knowledge Life Expectancy Measures Mediator Medicaid Medical Mental Health Mental disorders Mentored Research Scientist Development Award Mentors Monitor Morbidity - disease rate Onset of illness Outcome Outcome Study Participant Patients Performance Persons Pilot Projects Practice Management Protocols documentation Provider Randomized Recovery Reporting Research Research Design Research Personnel Risk Risk Factors Role Self Efficacy Self Management Services Social support Specialist Standardization Structure Surveys Technology Testing Time Training career comorbidity design early onset evidence base experience health disparity implementation barriers indexing intervention refinement mHealth mobile computing mortality mortality risk novel strategies patient engagement peer peer support physical conditioning programs psychiatric symptom self-management program service delivery severe mental illness skill acquisition skills systematic review therapy development

项目摘要

PROJECT SUMMARY Adults with serious mental illness (SMI) are disproportionately affected by medical comorbidity, earlier onset of disease, and 10 to 25 years reduced life expectancy compared to the general population. These high rates of morbidity and early mortality are associated with inadequately managed medical and psychiatric illnesses. Our systematic review found nine effective self-management interventions that address medical and psychiatric illnesses in adults with SMI. However, there has been limited adoption of these interventions due to both provider and patient-based factors. Provider-based barriers consist of the lack of an adequate workforce with the capacity, time, and knowledge of effective approaches to self-management support for adults with SMI and chronic health conditions. Patient-based barriers associated with limited participation in self-management programs include lack of access, engagement, and ongoing community-based support for persons with SMI. Peer support specialists have the potential to address these barriers as they comprise one of the fastest growing sectors of the mental health workforce, have “lived experience” in self-management practices, and offer access to support in the community. However, challenges need to be resolved for peers to be effective providers of evidence-based interventions. For example, peers are frequently trained to provide “peer support” described as “giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful”. Peer support has been associated with increased sense of control, ability to make changes, and decreased psychiatric symptoms. Despite benefits, peer support does not adhere to evidence-based practices for psychiatric and medical self-management and does not follow protocols that ensure fidelity and systematically monitor outcomes. We hypothesize that mobile technology has the potential to overcome these limitations of peer support by providing real-time guidance in fidelity adherent delivery of a peer-delivered, technology-assisted evidence-based self-management intervention (PDTA-IIMR). The purpose of this K01 award is to build the necessary expertise to pursue a career developing and testing novel approaches to peer-delivered evidence-based self-management interventions. Training will include: development of peer-delivered interventions; development and design of mobile health-supported interventions; and intervention clinical trials research. Concurrently, I propose to refine the intervention protocol with input from peers and patients. Then, I will conduct a pilot study evaluating the feasibility and potential effectiveness of PDTA-IIMR compared to routine peer support for N=6 peers and N=40 adults with SMI and chronic health conditions. Outcomes include feasibility, medical and psychiatric self-management skills, and functional ability. We will explore mortality risk factors and examine self-efficacy and social support as mechanisms on outcomes.

项目摘要患有严重精神疾病（SMI）的成年人受医疗合并症的影响不成比例，早期发作与普通人群相比，疾病和10至25年的预期寿命降低了。这些高度的发病率和早期死亡率与管理不足的医学和精神病有关。我们的系统评价发现了九种有效的自我管理干预措施，可以解决医学和精神病学成年人患有SMI的疾病。但是，由于两者，这些干预措施的采用有限提供者和基于患者的因素。基于提供者的障碍包括缺乏足够的劳动力 SMI和慢性健康状况。与参与自我管理有限有关的基于患者的障碍计划包括缺乏访问，参与度以及对SMI患者的持续基于社区的支持。同伴支持专家有可能解决这些障碍，因为它们是最快的障碍之一精神卫生员工的成长领域，在自我管理实践中具有“生活经验”，并且提供社区支持的访问权限。但是，需要解决挑战才能使同龄人有效基于证据的干预措施的提供者。例如，经常训练同伴以提供“同伴支持” 被描述为“基于尊重，共同责任和相互责任的关键原则的提供和接收帮助对有用的协议达成共识”。同伴支持与增加的控制感，能力相关进行更改，改善精神病症状。尽管有好处，同伴支持并不遵守基于循证的精神病和医学自我管理实践，并不遵循协议确保保真度并系统地监控结果。我们假设移动技术具有潜力通过提供实时指导来克服这些对同伴支持的局限同行提供的，技术辅助的基于证据的自我管理干预（PDTA-IIMR）。目的该K01奖是要建立必要的专业知识，以追求发展和测试小说的职业采用同行提供基于证据的自我管理干预措施的方法。培训将包括：开发同行分配的干预措施；移动健康支持的开发和设计干预措施；和干预临床试验研究。同时，我建议完善干预协议同龄人和患者的输入。然后，我将进行一项试点研究，以评估可行性和潜力与n = 6个同伴的常规同行支持和n = 40名成年人SMI和SMI和SMI和慢性健康状况。结果包括可行性，医疗和精神病学能力，以及功能能力。我们将探索死亡率风险因素，并将自我效能感和社会支持视为结局的机制。

项目成果

期刊论文数量（29）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Positive Organizational Psychology Factors as Serial Multiple Mediators of the Relationship between Organization Support and Job Satisfaction Among Peer Support Specialists.

积极组织心理学因素作为组织支持与同伴支持专家工作满意度之间关系的系列多重中介因素。

DOI：
10.1007/s10926-022-10054-7
发表时间：
2023
期刊：
Journal of occupational rehabilitation
影响因子：
3.3
作者：
Wu,JiaRung;Iwanaga,Kanako;Chan,Fong;Lee,Beatrice;Chen,Xiangli;Walker,Robert;Fortuna,KarenL;Brooks,JessicaM
通讯作者：
Brooks,JessicaM

Social Processes Associated With Health and Health Behaviors Linked to Early Mortality in People With a Diagnosis of a Serious Mental Illness.

与健康和健康行为相关的社会过程与诊断出严重精神疾病的人的早期死亡率有关。

DOI：
10.1177/1745691621990613
发表时间：
2022-01
期刊：
Perspectives on psychological science : a journal of the Association for Psychological Science
影响因子：
0
作者：
Fortuna KL;Williams A;Mois G;Jason K;Bianco CL
通讯作者：
Bianco CL

Attitudes and Beliefs on Aging Among Middle-Aged and Older Adults With Serious Mental Illness.

患有严重精神疾病的中老年人对老龄化的态度和信念。

DOI：
10.1016/j.jagp.2021.07.005
发表时间：
2022
期刊：
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
影响因子：
0
作者：
Lim,Carol;Moak,Gary;Fortuna,KarenL;Bianco,CynthiaL;Shakhau,Aliaksandr;Bruce,MarthaL;Bartels,Stephen
通讯作者：
Bartels,Stephen

Visioning the Future of Gerontological Digital Social Work.