Advancing the Early Psychosis Intervention Network in Texas (EPINET-TX)

项目总结/摘要 协调专科护理（CSC）已被证明是更有效的治疗首次发作 精神病（FEP）比通常的护理，导致更好的功能，更少的症状，更少的复发， 医院使用。自从联邦资金被取消以来，美国的CSC团队数量急剧增加。 提供支持各州的实施;德克萨斯州目前有26个CSC团队。这种早期的快速增长 精神病干预计划，以类似的核心特征运作，并为类似的参与者提供服务， 一个独一无二的机会通过使用一组标准的可靠服务和结果测量， 信息系统，以促进共享数据和反馈，并配备人员，以支持质量改进， 研究基础设施，得克萨斯州可以创造一个环境，在其中提供者，程序管理员， 决策者可以不断发展新知识。区域网络将把各种方案联系起来 通过德克萨斯州FEP联盟，支持基于测量的护理文化，并创建一个框架， 解决影响服务提供系统的研究问题，为研究文献做出贡献， 减轻精神病对年轻人及其家庭的负担。 对FEP患者的研究表明，共同发生的物质使用是常见的，可导致 精神病症状加重、药物依从性降低和长期结局较差。 研究表明，在FEP方案中，23%至73%的人继续使用药物。 经过6到12个月的护理。虽然社区支助方案模式纳入了从短暂干预和 解决药物使用问题的治疗模式，人们对这些策略在社区中的使用知之甚少， 基于计划或其有效性，在激励这一群体的年轻人减少或停止使用。的 一系列拟议的研究将促进对解决物质使用问题的关键问题的理解， 进入护理后继续使用的年轻人。第一项研究将使用图表审查方法来检查 标准的CSC模型干预是否成功地使参与者参与行为改变， 不同参与者（例如，非洲裔美国人，拉丁美洲人）直接将减少物质使用确定为 一个目标定性研究将检查CSC参与者和CSC同行专家对 同侪主导的支持物质使用恢复的干预措施的可行性和可接受性。合伙后 与同行专家和接受CSC服务的个人一起开发干预措施，将进行一项试点研究， 进行了研究部署、研究招募、保留和其他研究程序的可行性。 这项工作将为全州范围内与研究人员、决策者、供应商、年轻人和社区的伙伴关系奠定基础。 人们和他们的家庭成为一个医疗保健系统，使用数据来不断学习和转变。

PROJECT SUMMARY/ABSTRACT Coordinated specialty care (CSC) has been shown to be more effective for the treatment of first episode psychosis (FEP) than usual care, resulting in better functioning, fewer symptoms, fewer relapses, and less hospital use. The number of CSC teams has increased dramatically in the U.S. since federal funding has been provided to support states' implementation; Texas currently has 26 CSC teams. This rapid growth of early psychosis intervention programs, operating with similar core features and serving similar participants, provides a unique opportunity. By utilizing a standard battery of reliable service and outcome measures, a data informatics system to facilitate shared data and feedback, and staffing to support quality improvement and research infrastructure, Texas can create an environment in which providers, program administrators, and policy makers can continuously develop new knowledge. The regional network will link programs together through the Texas FEP Consortium, support a culture of measurement-based care, and create a framework for addressing research questions that impact the service delivery system, contribute to the research literature, and reduce the burden of psychosis on young people and their families. Research in persons with FEP has shown that co-occurring substance use is common and can lead to an exacerbation of psychotic symptoms, decreased medication adherence, and poorer long-term outcomes. Research has shown that between 23% and 73% of individuals in FEP programs continue to use substances after 6 to 12 months in care. While CSC models have incorporated practices from brief intervention and treatment models to address substance use, little is known about the use of these strategies in community- based programs or their effectiveness in motivating this group of young people to reduce or stop use. The series of proposed studies will advance an understanding of critical issues for addressing substance use in young people who continue use after entering care. The first study will use a chart review approach to examine whether standard CSC-model interventions are successful at engaging participants in behavior change and the extent to which diverse participants (e.g., African American, Latinx) directly identify reduced substance use as a goal. Qualitative studies will examining the perceptions of CSC participants and CSC peer specialists on the feasibility and acceptability of peer-led interventions for supporting substance use recovery. After partnering with peer specialists and individuals receiving CSC services to develop the intervention, a pilot study will be conducted to examine the feasibility of deployment, study recruitment, retention, and other study procedures. This work will set the stage for a statewide partnership with researchers, decision-makers, providers, young people and their families to become a healthcare system that uses data to continuously learn and transform.