Integrated Health Care for African Americans with Mental Illness Who Are Homeless

描述（由申请人提供）：无家可归的人身体疾病的发病率和患病率很高，并因同时发生的严重精神疾病而进一步加剧。非洲裔美国人受到无家可归者的影响尤为严重，多达50%的无家可归者是非洲裔美国人。在伊利诺伊州，无家可归的人口正在增加，预计将增加5%。在芝加哥，从2006年到2010年，避难所的使用率上升了28.4%，而没有避难所的人飙升至40.4%。Edgewater-Uptown地区的无家可归者同时患有精神疾病的比例是全国最高的。尽管针对这一人群提出并制定了综合护理计划，但它们的影响有限，部分原因是它们在制定和实施过程中没有充分纳入无家可归者的声音。因此，我们提出了一个基于社区的参与性研究（CBPR）项目，旨在针对无家可归且患有严重精神疾病的非裔美国人的医疗保健需求。与该小组进行的初步需求评估有助于指导这项建议。我们将建立一个社区咨询委员会（CAB），由有实际经验的非洲裔美国人组成，由包括一名有实际经验的非洲裔美国人在内的共同pi共同担任主席。CAB将控制该提案的所有方面。为了定义问题，我们将对有生活经验的人和其他利益相关者进行定性访谈，然后在定量调查中与第二组交叉验证这些信息。CAB将利用这些信息设计综合护理模式的干预措施。干预措施的可行性、可接受性和影响将在试点评估中进行测试。通过纵向设计（如基线、中点和随访），结果将包括感知可用性、项目满意度、身心健康和生活质量的评估。

DESCRIPTION (provided by applicant): People who are homeless have high incidence and prevalence of physical illnesses that are further exacerbated by co-occurring serious mental illnesses. African Americans are disproportionately affected by homelessness with as many as 50 percent of homeless people being African American. In Illinois, the homeless population is increasing and expected to rise 5 percent. In Chicago from 2006-2010, shelter use rose 28.4 percent and those unsheltered surged to 40.4 percent. One neighborhood especially hard hit is the Edgewater-Uptown area with among the highest rate of homeless people with co-occurring mental illness in the country. Although integrated care programs have been proposed and developed for this population, they have limited impact in part because they have not fully incorporated the voice of the homeless in development and implementation. Hence, we propose a community based participatory research (CBPR) project meant to target the health care needs of African Americans who are homeless with serious mental illness. A preliminary needs assessment with the group has helped to direct this proposal. We will establish a Community Advisory Board (CAB) comprised of African Americans with lived experience and co-chaired by the co-PIs including an African American with lived experience. The CAB will have control over all aspects of this proposal. To define the problem, we will conduct qualitative interviews of people with lived experience and other stakeholders and then cross-validate this information with a second group in a quantitative survey. The CAB will use this information to design an intervention using an integrated care model. Feasibility, acceptability, and impact of the intervention will then be tested in a pilot evaluation. Outcomes will include assessments of perceived availability, program satisfaction, physical and mental health, and quality of life with longitudinal design (e.g., baseline, midpoint, and follow-up). RELEVANCE (See Instructions): African Americans who are homeless with serious mental illness suffer a catastrophic level of morbidity and mortality. Through community based participatory research, we will identify specific health concerns of this population in Chicago's Edgewater-Uptown neighborhood and develop an integration meant to promote integrated care therein. The project will also include a pilot investigation of the acceptability and impact of thi intervention.