The Cultural Formulation Interview-Engagement Aid for Mental Health Treatment

描述（由申请人提供）：拟议的指导患者导向研究职业发展奖（K23）是一个为期四年的计划，将使候选人能够发展成为具有独立研究计划的干预发展，服务研究人员。本研究计划的目标是通过开发一种跨文化交流参与援助，确定在开始、继续和参与治疗时相关的文化观点，从而提高心理健康机构中服务不足的种族和少数民族人群的治疗参与程度。我们将测试干预对医疗沟通和患者预后的影响。培训目标是：1)干预开发培训；2)研究如何克服参与的文化障碍，重点关注治疗的进入、持续和参与；3)获得评估跨文化误解如何导致治疗脱离和健康差异的方法学技能；4)临床试验方法学和纵向数据分析培训。该应用程序集成了正式的课程工作，从建立调查员的指导，并指导研究活动。在候选人培训计划的支持下，提出了三项研究，从干预开发转向试点测试。项目1由三个独立的焦点小组组成，包括患者、临床医生和管理人员，以确定项目目标、方法和策略，以促进少数民族精神疾病患者的治疗进入、参与和持续。候选人将向这些不同的利益相关者展示关于这些主题的文献综述的结果，以将理论方法转化为实践策略。这个为期12个月的项目的目标是设计干预措施，为临床医生编写第一本指导手册，并为干预制定临床医生的依从性和能力措施。项目2是一个小型的预试点开放研究，训练有素的临床医生将提供干预措施。与患者和临床医生进行汇报访谈将确定影响干预的可行性和可接受性的因素，并随后修订干预的指导手册。然后，将根据具有保真度指标的适应干预措施为临床医生修订实施计划。项目3是一项小型试点随机对照试验，旨在检查适应性干预的可行性和可接受性，并探索其与公共门诊精神卫生诊所常规护理的初始疗效。根据实施图，一个由患者、临床医生、管理人员、导师和顾问组成的科学咨询委员会（SAB）将用于在所有项目中纳入多个利益相关者的观点。这些项目的结果将作为申请后续赠款的试点数据。

DESCRIPTION (provided by applicant): The proposed Mentored Patient-Oriented Research Career Development Award (K23) is a four-year plan that will enable the candidate to develop as an intervention development, services researcher with an independent program of research. The goal of this research program is to improve the treatment engagement of underserved racial and ethnic minority populations in mental health settings by developing a cross-cultural communication engagement aid that ascertains relevant cultural views in starting, continuing, and participating in treatment. We will test the intervention's effects on medical communication and patient outcomes. The training objectives are to: 1) train in intervention development; 2) study how to overcome cultural barriers to engagement, focusing on treatment entry, continuation, and participation; 3) acquire methodological skills to assess how cross-cultural miscommunication leads to treatment disengagement and health disparities; 4) train in clinical trials methodology and longitudinal data analysis. The application integrates formal course work, mentorship from established investigators, and mentored research activities. Three studies, supported by the candidate's training plan, are proposed that move from intervention development to pilot testing. Project 1 consists of three separate focus groups with patients, clinicians, and administrators to define program objectives, methods, and strategies to promote treatment entry, participation, and continuation of minorities with mental illness. The candidate will present these diverse stakeholders with results from a literature review on these topics to translate theoretical methods into practical strategies. The goals of this 12-month program are to design the intervention, write the first instruction manual for clinicians, and to develop cliniian adherence and competence measures for the intervention. Project 2 is a small, pre-pilot, open study in which trained clinicians will deliver the intervention. Debriefing interviews with patient and clinicians will identify factors affecting feasibility and acceptability with subsequent revisin of the intervention's instruction manual. An implementation plan will then be revised for clinicians based on the adapted intervention with fidelity indicators. Project 3 is a small pilot RCT to examine the feasibility and acceptability of the adapted intervention and explore its initia efficacy versus usual care at a public outpatient mental health clinic. Drawing from implementation mapping, a Scientific Advisory Board (SAB) consisting of patients, clinicians, administrators, mentors, and consultants will be used to incorporate the perspectives of multiple stakeholders in all projects. Results from these projects will serve as pilot data to apply for subsequent grants.