Advancing the Early Psychosis Intervention Network in Texas (EPINET-TX)

项目摘要/摘要 协同专科护理(CSC)已被证明对首发病例的治疗更有效 精神病(FEP)比通常的护理更好，症状更少，复发更少，更少 医院使用。自从联邦政府资助以来，CSC团队在美国的数量急剧增加 提供支持各州的实施；德克萨斯州目前有26个CSC团队。早期的这种快速增长 具有相似核心特征并为相似参与者提供服务的精神病干预计划，提供 一个难得的机会。通过利用可靠的服务和结果衡量的标准电池，数据 信息学系统，以促进共享数据和反馈，并配备人员，以支持质量改进和 得克萨斯州的研究基础设施可以创造一个环境，在这个环境中，提供商、计划管理员和 政策制定者可以不断发展新的知识。该地区网络将把项目联系在一起 通过德克萨斯FEP联盟，支持以测量为基础的护理文化，并为 解决影响服务提供系统的研究问题，为研究文献做出贡献， 并减轻年轻人及其家庭的精神病负担。 对FEP患者的研究表明，共生物质的使用很常见，并可能导致 精神病症状加重，服药依从性降低，长期疗效较差。 研究表明，在FEP计划中，23%到73%的人继续使用物质 在护理6至12个月后。虽然CSC模式融入了短暂干预和 针对物质使用的治疗模式，人们对这些策略在社区中的使用知之甚少。 基于计划或其在激励这群年轻人减少或停止使用方面的有效性。这个 拟议的一系列研究将促进对解决#年物质使用问题的关键问题的理解 进入托儿所后继续使用的年轻人。第一项研究将使用图表回顾的方法来检查 标准的CSC模型干预是否成功地让参与者参与到行为改变和 不同参与者(例如，非裔美国人、拉丁裔)直接确定减少物质使用的程度 一个进球。定性研究将考察CSC参与者和CSC同行专家对 同行主导的支持药物使用恢复的干预措施的可行性和可接受性。在合作之后 与同行专家和接受CSC服务的个人一起制定干预措施，将进行一项试点研究 进行的目的是检查部署、研究招募、保留和其他研究程序的可行性。 这项工作将为全州范围内与研究人员、决策者、提供者、青年 人们及其家人将成为一个使用数据不断学习和转变的医疗保健系统。

PROJECT SUMMARY/ABSTRACT Coordinated specialty care (CSC) has been shown to be more effective for the treatment of first episode psychosis (FEP) than usual care, resulting in better functioning, fewer symptoms, fewer relapses, and less hospital use. The number of CSC teams has increased dramatically in the U.S. since federal funding has been provided to support states' implementation; Texas currently has 26 CSC teams. This rapid growth of early psychosis intervention programs, operating with similar core features and serving similar participants, provides a unique opportunity. By utilizing a standard battery of reliable service and outcome measures, a data informatics system to facilitate shared data and feedback, and staffing to support quality improvement and research infrastructure, Texas can create an environment in which providers, program administrators, and policy makers can continuously develop new knowledge. The regional network will link programs together through the Texas FEP Consortium, support a culture of measurement-based care, and create a framework for addressing research questions that impact the service delivery system, contribute to the research literature, and reduce the burden of psychosis on young people and their families. Research in persons with FEP has shown that co-occurring substance use is common and can lead to an exacerbation of psychotic symptoms, decreased medication adherence, and poorer long-term outcomes. Research has shown that between 23% and 73% of individuals in FEP programs continue to use substances after 6 to 12 months in care. While CSC models have incorporated practices from brief intervention and treatment models to address substance use, little is known about the use of these strategies in community- based programs or their effectiveness in motivating this group of young people to reduce or stop use. The series of proposed studies will advance an understanding of critical issues for addressing substance use in young people who continue use after entering care. The first study will use a chart review approach to examine whether standard CSC-model interventions are successful at engaging participants in behavior change and the extent to which diverse participants (e.g., African American, Latinx) directly identify reduced substance use as a goal. Qualitative studies will examining the perceptions of CSC participants and CSC peer specialists on the feasibility and acceptability of peer-led interventions for supporting substance use recovery. After partnering with peer specialists and individuals receiving CSC services to develop the intervention, a pilot study will be conducted to examine the feasibility of deployment, study recruitment, retention, and other study procedures. This work will set the stage for a statewide partnership with researchers, decision-makers, providers, young people and their families to become a healthcare system that uses data to continuously learn and transform.