Illness Management and Recovery Program: IMR-Web

疾病管理和康复计划：IMR-Web

• 批准号: 7677772
• 负责人: JAMES P O'HALLORAN
• 金额: $ 25万
• 依托单位: NEUROCOMP SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7677772
• 关键词: Address; Adoption; Adult; Behavior Therapy; Behavioral; Brain Diseases; Caring; Charge; Client; Clinic; Clinical; Cognitive; Communities; Computer Assisted; Computers; Consumer Participation; Coping Skills; Development; Educational Curriculum; Ensure; Evidence based practice; Facilities and Administrative Costs; Family; Freedom; Goals; Health Personnel; Health system; Healthcare; Healthcare Systems; Hour; Indiana; Individual; Internet; Intervention; Interview; Knowledge; Lead; Learning; Manuals; Measures; Mental Health; Methods; Morbidity - disease rate; Multimedia; Network-based; Online Systems; Outcome; Paper; Participant; Pharmaceutical Preparations; Phase; Population; Productivity; Provider; Public Health; Quality of life; Recovery; Rehabilitation therapy; Reliance; Reporting; Resources; Schizophrenia; Self Administration; Self Management; Services; Small Business Innovation Research Grant; Societies; Solutions; Standardization; Surveys; Symptoms; System; Target Populations; Techniques; Technology; Time; Training; Training Programs; Translating; United States Substance Abuse and Mental Health Services Administration; Visit; Work; base; computerized; cost; design; disorder later incidence prevention; evidence base; experience; high standard; improved; interactive multimedia; literacy; medication compliance; meetings; mental health organization; mortality; programs; prototype; psychoeducation; public health relevance; rehabilitation management; research study; severe mental illness; skills; skills training; social; social skills; software systems; standard of care; success; tool; touchscreen; treatment center; usability; web-enabled

DESCRIPTION (provided by applicant): Serious mental illnesses (SMI) exact a high toll on society, both in terms of direct and indirect costs of health care and lost productivity, and in terms of the suffering of inflicted individuals and their families. Mental health provider organizations have been charged with transforming the services they provide to improve the outcomes of clients with SMI. An increasingly important component of these services are intensive, evidence-based rehabilitation interventions that improve illness self-management, functioning, and quality of life. However, dissemination of these interventions has been severely limited because community mental health agencies often lack sufficient clinician time and expertise. The Illness Management and Recovery(IMR) program is the first comprehensive, evidence-based, self-management training program selected by SAMHSA (Substance Abuse & Mental Health Services Administration) for national dissemination. IMR is a curriculum-based program that enables clients to set and achieve personal recovery goals, and acquire the knowledge and skills necessary to manage their illnesses independently. IMR was developed as part of the National Implementing Evidence-Based Practices Project and is comprised of five evidence-based practices: psychoeducation, cognitive-behavioral approaches to medication adherence, relapse prevention, social skills training, and coping skills training for persistent symptoms. The paper-based IMR program (e.g. workbooks and manuals) has been implemented in demonstration projects (within 5 states). However, it has proven relatively labor intensive and too costly for the vast majority of programs. In addition, the accessibility of the paper-based IMR program is limited by the number of trained clinicians who can efficiently provide the intervention. An insightful solution to this limitation is to computerize self-administration of IMR modules via the internet. There has been proven substantial success with internet-based, audio, computer-assisted, self-interviewing technology that meets the needs of individuals with SMI, including cognitive deficiencies, limited literacy, and little or no computer expertise. In this project, a dedicated touchscreen kiosk at clinics will provide a browser-based connection to "IMR-Web", an internet tool that supports clients as they engage in IMR. IMR materials will be translated into interactive, engaging, multimedia presentations with simplified navigation requirements. While IMR-Web does not replace clinicians, it will substantially reduce the demands for clinician time and intensive training in the full IMR curriculum. IMR-Web has the potential to efficiently support broad utilization of IMR, improve standardization of IMR delivery, and enhance consumer involvement, while reducing resource requirements for provider organizations. IMR-Web will track client progress and help clinicians better identify challenges to address during treatment visits. This project is a partnership between NeuroComp, IMR developers, and RAND. In Phase I, two exemplary IMR modules will be computerized and evaluated in clients with SMI. Primary determinants of feasibility will be usability-acceptability, ability to complete modules, and retention of critical information by clients. PUBLIC HEALTH RELEVANCE: Persistent, Serious Mental Illness (SMI) exacts a tremendous toll on society, afflicting approximately 15M US citizens. Costs can be defined and measured both in terms of indirect and direct impact on the health care system, lost productivity and most importantly, suffering of the individuals and their families. The proposed IMR-Web will provide a highly efficient, computerized, web-enabled, method of implementing the Illness Management and Recovery (IMR) program in a manner that will enable much broader adoption by States and health care management systems. IMR-Web will be the first web-enabled, evidence-based recovery program selected by the Substance Abuse and Mental Health Services Administration (SAMHSA) for national implementation. IMR-Web will lead to more rapid, cost-effective adoption of the powerful and comprehensive IMR program.

描述（由申请人提供）：严重精神疾病 (SMI) 对社会造成巨大损失，包括直接和间接的医疗保健成本和生产力损失，以及患者及其家人的痛苦。心理健康提供者组织负责改变他们提供的服务，以改善 SMI 客户的治疗结果。这些服务的一个日益重要的组成部分是强化的、基于证据的康复干预措施，以改善疾病的自我管理、功能和生活质量。然而，由于社区心理健康机构往往缺乏足够的临床医生时间和专业知识，这些干预措施的传播受到严重限制。疾病管理和康复 (IMR) 计划是第一个由 SAMHSA（药物滥用和心理健康服务管理局）选择在全国传播的综合性、循证自我管理培训计划。 IMR 是一项基于课程的计划，使客户能够设定并实现个人康复目标，并获得独立管理疾病所需的知识和技能。 IMR 是国家实施循证实践项目的一部分，由五种循证实践组成：心理教育、药物依从性的认知行为方法、预防复发、社交技能培训和针对持续症状的应对技能培训。纸质 IMR 计划（例如工作簿和手册）已在示范项目中实施（5 个州内）。然而，事实证明，对于绝大多数项目来说，它是相对劳动密集型的且成本过高。此外，纸质 IMR 计划的可及性受到能够有效提供干预的训练有素的临床医生数量的限制。解决这一限制的一个富有洞察力的解决方案是通过互联网对 IMR 模块进行计算机化自我管理。事实证明，基于互联网的音频、计算机辅助、自我访谈技术能够满足 SMI 患者的需求，包括认知缺陷、读写能力有限以及很少或没有计算机专业知识。在该项目中，诊所的专用触摸屏信息亭将提供基于浏览器的“IMR-Web”连接，这是一种支持客户参与 IMR 的互联网工具。 IMR 材料将被转化为具有简化导航要求的交互式、引人入胜的多媒体演示。虽然 IMR-Web 不会取代临床医生，但它将大大减少临床医生在完整 IMR 课程中的时间和强化培训的需求。 IMR-Web 有潜力有效支持 IMR 的广泛利用，提高 IMR 交付的标准化，并增强消费者的参与，同时减少对提供商组织的资源需求。 IMR-Web 将跟踪客户的进展并帮助临床医生更好地识别治疗就诊期间需要解决的挑战。该项目是 NeuroComp、IMR 开发商和兰德之间的合作伙伴关系。在第一阶段，两个示例性 IMR 模块将被计算机化并在 SMI 客户中进行评估。可行性的主要决定因素是可用性、可接受性、完成模块的能力以及客户保留关键信息。公共卫生相关性：持续、严重的精神疾病 (SMI) 给社会造成巨大损失，影响了大约 1500 万美国公民。成本可以根据对医疗保健系统的间接和直接影响、生产力损失以及最重要的是个人及其家庭的痛苦来定义和衡量。拟议的 IMR-Web 将提供一种高效、计算机化、网络化的方法来实施疾病管理和康复 (IMR) 计划，从而使各国和医疗保健管理系统能够更广泛地采用。 IMR-Web 将是药物滥用和心理健康服务管理局 (SAMHSA) 选择在全国实施的第一个基于网络的、基于证据的康复计划。 IMR-Web 将导致更快速、更经济高效地采用强大且全面的 IMR 计划。