A Promotora-centric Community Collaborative to Improve Connections to Mental Health Services

项目总结/摘要 近70%的拉丁裔精神健康障碍患者由于各种原因未能获得所需的治疗。 获得特定文化精神卫生保健的障碍。 我们建议，特别值得信赖的声音可能能够减少心理健康的耻辱， 社区和加强社交网络，以改善精神卫生服务的联系。以西班牙语在社区中，被称为促进者的非专业卫生工作者扮演着这样的角色：促进者充当教育者， 文化经纪人，社区和卫生服务之间的桥梁。 我们将与一个促进学习的合作，以制定和评估一个社区范围内的心理健康 开展教育和赋权运动，以增加有关心理健康、创伤和 支持服务，并改善东圣何塞拉丁裔人口对精神卫生服务的利用， 约透过与社区伙伴合作，我们致力达致以下目标：1） 绘制社区内精神卫生服务的景观和途径; 2）加强 促进者的能力，使他们的社区周围的精神卫生服务的使用;和3）确定是否 让发起人参与心理健康教育和赋权运动， 全社会的服务使用。 在第一个目标下，我们将与社区合作伙伴和推广人合作，创造丰富的社区资产 文化特定的精神卫生服务地图，分层与来自社区范围的评估结果， 心理健康服务使用，使用地理信息系统制图（GIS）。然后，Promotoras将 接受培训，以促进心理健康教育，（自我）效能和（结果）期望（MHE 3）聚会- 共同创建的针对特定文化的干预措施，以改善心理健康服务的使用。最后，在第三个目标中，我们 将实施MHE 3作为一个集群随机试验，并确定其对个人，人际， 社区层面。除了自我报告的结果外，我们还将调查对社交网络的影响， 确定和选择心理健康服务。我们将联合收割机从现有的设施为基础的调查结果， 数据与新收集的年度社会横断面调查结果，以确定更广泛的 社区层面对精神卫生服务使用的影响。 了解promotoras如何帮助克服心理健康和服务使用的障碍将提供见解 这为与促进者合作并将其纳入护理途径和提供战略提供了信息， 更广泛地减少拉丁裔社区之间的心理健康差距。此外，我们认为这项工作 还可以作为如何向其他得不到充分服务的人口开展外联的模板。最后 拟议的研究将进一步推进NIMH的使命，即通过测试加强研究对公共卫生的影响 创新方法，减少获得护理方面的差距。

PROJECT SUMMARY / ABSTRACT Almost 70% of Latinx people with mental health disorders fail to receive the treatment they need due to various barriers to accessing culturally specific mental health care. We propose that particularly trusted voices might be able to decrease mental health stigma in their communities and strengthen social networks to improve mental health services connections. In Spanishspeaking communities, lay health workers called promotoras fulfill this role: promotoras act as educators, cultural brokers, and bridges between the community and health services. We will engage with a promotora learning collaborative to develop and assess a community-wide mental health education and empowerment campaign to increase culturally specific knowledge of mental health, trauma, and support services and to improve mental health services utilization in the Latinx population of East San José, CA. By collaborating with deep-rooted community partners, we seek to achieve the following specific aims: 1) Map the landscape of and pathways to mental health services within the community; 2) Strengthen promotoras’ capacity to engage their community around mental health services use; and 3) Determine if engaging promotoras in a mental health education and empowerment campaign increases mental health services utilization community-wide. Under the first aim, we will work with community partners and promotoras to create a rich community asset map of culturally specific mental health services, layered with findings from a community-wide assessment of mental health services use, using geographic information system mapping (GIS). Promotoras will then be trained to facilitate Mental Health Education, (self-)Efficacy, and (outcomes) Expectancy (MHE3) gatherings – a co-created culturally specific intervention to improve mental health services use. Finally, in the third aim, we will implement MHE3 as a cluster randomized trial and determine its impact at the individual, interpersonal, and community levels. Beyond self-reported outcomes, we will investigate the impact on social networks used to identify and choose mental health services. We will combine findings from existing facility-based and claims data with the results of a newly collected annual cross-sectional survey of the community to determine broader community-level impact on mental health services use. Understanding how promotoras help overcome barriers to mental health and services use will deliver insights that inform collaboration with and integration of promotoras into care pathways and delivery strategies to decrease mental health disparities among Latinx communities more widely. Furthermore, we believe this work can also serve as a template for how to conduct outreach to other underserved populations. Finally, the proposed research will further NIMH’s mission to strengthen the public health impact of research by testing innovating approaches to reduce disparities in care access.