GET PrEPD for Psychiatry: Goal Elicitation, Treatment Prioritization, & Electronically-Practiced Discussion for Psychiatric Care

精神病学 GET PrEPD：目标引导、治疗优先顺序、

• 批准号: 10057272
• 负责人: ADAM T HIRSH
• 金额: $ 19.34万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-12-01 至 2022-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057272
• 关键词: Address; Adult; Attitude; Caring; Clinic Visits; Clinical Trials; Code; Communication; Communities; Community Mental Health Centers; Complex; Computers; Coupled; Data; Decision Making; Development; Educational process of instructing; Elements; Ethics; Feedback; Funding; Goals; Health Personnel; Individual; Informal Social Control; Intervention; Intervention Trial; Language; Learning; Life; Medication Management; Mental Health; Mental Health Services; National Institute of Mental Health; Outcome; Participant; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Process; Provider; Psychiatric therapeutic procedure; Psychiatry; Public Health; Recovery; Reporting; Research; Resources; Self Efficacy; Self Management; Series; Service delivery model; Services; Structure; Symptoms; System; Technology; Testing; Text; Time; Training; Transcript; Translations; Visit; Work; acceptability and feasibility; base; chronic care model; chronic pain; chronic pain patient; cognitive interview; cost; design; effectiveness trial; experience; health care quality; improved; informant; innovation; instrument; novel; peer support; person centered; personalized medicine; preference; programs; recruit; response; satisfaction; severe mental illness; shared decision making; skills; support tools; theories; usability; virtual; virtual reality simulator

Project Summary/Abstract This project will develop an innovative intervention to increase patient activation and communication self- efficacy so that adults with severe mental illnesses (SMI) can engage in shared decision-making (SDM) and optimize recovery outcomes. SDM -- a process in which patients and providers work collaboratively to make decisions -- is an ethical imperative and is critical for high-quality, recovery-oriented care. Yet, despite efforts to implement recovery-oriented care, people with SMI still have difficulty engaging as active partners in psychiatric treatment. Moreover, few SDM interventions have been developed specifically for people with SMI, and the most well-known is a highly resource-intensive program. The current proposal outlines a pilot effectiveness trial of a low-cost, high-innovation approach called GET PrEPD-Psychiatry (Goal Elicitation, Treatment Prioritization, & Electronically-Practiced Discussion). Originally developed to enhance SDM in chronic pain patients, GET PrEPD-Psychiatry participants receive individual in-person coaching to clarify/prioritize their goals, determine treatment preferences and rationale for these preferences, and develop skills to engage in SDM. Patients will practice these skills in online interactions with Virtual Providers, which will be tailored to patients' unique learning styles, thereby, enhancing skills mastery and communication self- efficacy. This pilot effectiveness trial includes three aims. First, the research team will adapt the Virtual Providers used in the original GET PrEPD for chronic pain for use in psychiatric decision-making – they will do so by analyzing existing audio-recordings of 200 psychiatric visits collected in their prior NIMH-funded study. Content analysis will identify relevant conversations that will be used to program the online Virtual Providers, and a series of iterative tests with patients and feedback from consultants will refine the intervention. The second aim is to pilot test the adapted GET PrEPD-Psychiatry to establish feasibility and acceptability of the intervention in 40 adults with SMI in a community mental health center. Finally, the research team will identify potential mechanisms of change and examine preliminary outcomes of GET PrEPD-Psychiatry, hypothesizing that following participation in GET PrEPD-Psychiatry, patients will 1) report improved activation and communication self-efficacy, 2) demonstrate improved SDM in treatment sessions with their psychiatric providers, and 3) report improved self-management and recovery attitudes. Successful completion of this project will result in a new, highly scalable intervention that can be implemented across a range of psychiatric treatment settings to reach a large number of patients, directly addressing an NIMH strategic goal to develop innovative service delivery models. Following successful completion of this R34, the research team will be well- poised to evaluate mechanisms of change and recovery outcomes in a rigorous clinical trial of the intervention.

项目总结/摘要 该项目将开发一种创新的干预措施，以增加患者的激活和沟通自我， 有效性，以便患有严重精神疾病（SMI）的成年人可以参与共同决策（SDM）， 优化恢复结果。SDM --患者和提供者合作的过程， 决策-是一项道德义务，对高质量、以康复为导向的护理至关重要。然而，尽管努力 实施以恢复为导向的护理，重度精神障碍患者仍然难以作为积极的合作伙伴参与 精神治疗此外，很少有专门针对重度精神障碍患者的SDM干预措施， 其中最著名的是一个高度资源密集型的项目。目前的提案概述了一个试点项目， 一种低成本、高创新的方法的有效性试验，称为GETPrEPD-Psychiatry（目标诱导， 治疗优先化和电子实践讨论）。最初是为了加强可持续发展机制， 慢性疼痛患者，GET PrEPD-Psychiatry参与者接受个人面对面辅导， 明确/优先考虑他们的目标，确定治疗偏好和这些偏好的理由，并制定 参与SDM的技能。患者将在与虚拟提供者的在线互动中练习这些技能， 根据患者独特的学习风格量身定制，从而提高技能掌握和自我沟通能力， 功效这一试点成效试验包括三个目标。首先，研究团队将调整虚拟 在最初的GET PrEPD中用于慢性疼痛的提供者用于精神病决策-他们会这样做 因此，通过分析在他们之前的NIMH资助的研究中收集的200次精神病访问的现有录音。 内容分析将确定相关的对话，这些对话将用于对在线虚拟提供商进行编程， 一系列反复的病人测试和顾问的反馈将完善干预措施。的 第二个目标是对改编后的GET PrEPD-精神病学进行试点测试，以确定其可行性和可接受性。 在社区精神卫生中心对40名患有SMI的成年人进行干预。最后，研究小组将确定 潜在的变化机制，并检查GET PrEPD精神病学的初步结果，假设 参加GET PrEPD-精神病学后，患者将1）报告激活改善， 沟通自我效能，2）在精神病患者的治疗过程中表现出改善的SDM 提供者，和3）报告改善自我管理和恢复的态度。成功完成本 该项目将产生一种新的、高度可扩展的干预措施，可以在一系列精神病学领域实施 治疗设置，以达到大量的患者，直接解决NIMH的战略目标，以发展 创新的服务提供模式。在成功完成R34之后，研究团队将很好地- 准备在一项严格的干预临床试验中评估变化机制和恢复结果。