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

描述（由申请人提供）：无家可归的人有身体疾病的高发病率和患病率，这些疾病因同时发生的严重精神疾病而进一步加剧。非裔美国人不成比例地受到无家可归者的影响，多达50%的无家可归者是非裔美国人。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，住房使用率上升了28.4%，而那些没有住房的人则飙升至40.4%。一个受打击特别严重的社区是埃奇沃特住宅区，那里是全国无家可归者同时患有精神疾病的比例最高的地区之一。虽然已经为这一群体提出并制定了综合护理方案，但这些方案的影响有限，部分原因是这些方案在制定和实施过程中没有充分考虑到无家可归者的声音。因此，我们提出了一个基于社区的参与式研究（CBPR）项目，旨在针对无家可归的非洲裔美国人的医疗保健需求与严重的精神疾病。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），由具有生活经验的非裔美国人组成，并由包括一名具有生活经验的非裔美国人在内的共同PI担任共同主席。CAB将控制本提案的所有方面。为了确定问题，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人交叉验证这些信息。CAB将使用这些信息设计一个综合护理模式的干预措施。然后将在试点评估中检验干预措施的可行性、可接受性和影响。结果将包括对感知可用性、计划满意度、身心健康以及纵向设计的生活质量的评估（例如，基线、中点和随访）。 相关性（见说明）：非洲裔美国人谁是无家可归的严重精神疾病遭受灾难性的发病率和死亡率水平。通过以社区为基础的参与性研究，我们将确定在芝加哥的埃奇沃特住宅区附近的这一人群的具体健康问题，并制定一项旨在促进综合保健的整合。该项目还将包括一个试点调查的可接受性和影响，这种干预。

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.