COMMUNITY PARTNERS IN CARE

护理社区合作伙伴

• 批准号: 7852301
• 负责人: KENNETH B. WELLS
• 金额: $ 15.23万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-05 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7852301
• 关键词: Administrator; Adolescent; Adoption; African American; Attitude; Caring; Client; Clinical; Color; Communities; Coupled; Discipline; Disease; Effectiveness; Evidence based intervention; Evidence based treatment; Experimental Models; Exposure to; Face; Grant; Health; Health Services Accessibility; Health Services Research; High Prevalence; Improve Access; Income; Intervention; Knowledge; Latino; Learning; Los Angeles; Low income; Medication Management; Mental Health; Methods; Minority; Modeling; Neighborhoods; Outcome; Outcome Study; Patients; Primary Health Care; Process; Protocols documentation; Provider; Psychological reinforcement; Psychotherapy; Quality of Care; Randomized; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Research; Research Design; Research Personnel; Resources; Services; Site; Social Sciences; Social Work; Time; Training; Treatment outcome; Waiting Lists; Work; base; burden of illness; control trial; cost; depression; effectiveness trial; ethnic minority population; evidence base; follow-up; improved; innovation; interest; medical specialties; programs; safety net; symposium; therapy design; treatment as usual; uptake; web site

DESCRIPTION (provided by applicant): Underserved communities of color face an excess burden of illness from depression, due to the high prevalence of depression coupled with lower access to quality care among the poor. While evidence-based quality improvement programs for depression exist, these programs are under-utilized in underserved communities and have not been used across multiple agencies supporting safety-net clients. This is a revised proposal for Community Partners in Care (CPIC), a study designed to examine the effectiveness of a community-engagement, network-building intervention to implement evidence-based quality improvement interventions (PIC/WE Care) for depression within a multi-agency context, relative to a low-intensity dissemination control condition. Effectiveness is examined in terms of a) client access to care, health outcomes and quality of care; b) implementation process and costs; c) provider and administrator adoption of PIC/WE Care protocols and knowledge and attitudes concerning depression care and quality improvement toolkits. We propose a group level randomized control trial (RCT) in two Los Angeles Communities, South Los Angeles and Hollywood. The unit of randomization is the site or independent team of a participating agency. Agencies will include social service, primary care, and mental health specialty organizations. The study is longitudinal at the client, clinician, and organizational levels. Agencies and providers will be recruited and their sites randomized to the intervention or control condition. A community conference orients all sites to the study, provides the control condition and initiates planning under a community engagement model for the experimental sites. Clients will be recruited from intervention and control sites into a one-year outcomes study. Following the trial, the control sites receive delayed training in use of PIC/WE Care toolkits. We propose to evaluate uptake of these programs across four years as organizations have the intervention (either initially versus control condition; or in the wait-list delayed training for controls). We propose to use mixed methods to study the process of implementation of evidence-based interventions in underserved communities, under both the intervention and control conditions. The project investigators and community leaders represent diverse clinical and social science disciplines. The project is conducted, overall, under a community participatory partnered approach.

描述（由申请人提供）：由于抑郁症的高患病率加上穷人获得优质护理的机会较少，服务不足的有色人种社区面临着抑郁症带来的过度疾病负担。虽然存在基于证据的抑郁症质量改进计划，但这些计划在服务不足的社区中未得到充分利用，并且尚未在支持安全网客户的多个机构中使用。这是一个修订后的建议，社区合作伙伴在照顾（CPIC），一项研究，旨在研究社区参与，网络建设干预措施的有效性，以实施循证质量改进干预措施（PIC/WE护理）的抑郁症在多机构的背景下，相对于低强度的传播控制条件。有效性检查方面：a）客户获得护理，健康结果和护理质量; B）实施过程和成本; c）提供者和管理员采用PIC/WE护理协议和知识和态度有关抑郁症护理和质量改进工具包。我们建议在两个洛杉矶社区（南洛杉矶和好莱坞）进行组水平随机对照试验（RCT）。随机化单位是研究中心或参与机构的独立团队。机构将包括社会服务，初级保健和心理健康专业组织。这项研究是纵向的客户端，临床医生和组织层面。将招募机构和提供者，并将其研究中心随机分配至干预或对照条件。一个社区会议定位所有网站的研究，提供控制条件，并启动规划下的社区参与模式的实验地点。将从干预和对照研究中心招募患者，进行为期一年的结果研究。试验结束后，对照研究中心接受了使用PIC/WE Care工具包的延迟培训。我们建议在四年内评估这些计划的吸收，因为组织有干预措施（无论是最初与控制条件;或在等待名单延迟培训控制）。我们建议使用混合的方法来研究在服务不足的社区，在干预和控制条件下实施循证干预的过程。项目研究人员和社区领导人代表不同的临床和社会科学学科。总体而言，该项目是在社区参与伙伴关系的方式下进行的。