CBPR to Improve Depression Care for African-American Domestic Violence Survivors

与白人相比，非裔美国人接受的抑郁症治疗更少。同样，有 亲密伴侣暴力(IPV)的历史增加了抑郁症的发生率和对精神上更大的不信任 医疗保健。然而，很少有心理健康治疗方案专门解决老年人的复杂需求 非裔美国人虐待幸存者。我们计划使用基于社区的参与性研究(CBPR)来 开发和测试以社区为基础的多方面干预措施，以减少非洲裔美国人的抑郁症差异 有过IPV经历的女性。这项建议的目的是为了加强我们的社区学术 合作伙伴关系，并获得进行大规模 对照试验。我们的伙伴关系包括非裔美国人IPV幸存者、社区领袖、国内 暴力倡导者、精神健康提供者和研究人员已经在共同努力 了解沮丧的非裔美国人IPV幸存者的信仰和需求。我们现在正在开发一种 基于康复根中心的抑郁症护理模式，该中心是一家以社区为基础的非裔美国家庭 暴力节目。我们的干预包含了许多相同的原则，这些原则包括在基于 慢性护理模式，但它将社区及其资源置于该计划的核心。非洲裔美国人 家庭暴力倡导者将扮演类似护理管理者的角色，提供护理 协调和耐心教育。他们将把IPV幸存者与医疗保健系统联系起来，并赋予 他们与现场和诊所提供者进行更有效的互动。倡导者将使用 激励性面试技巧，帮助女性做出她们希望在文化上合适的行为改变 举止。最后，我们将纳入创造性的、以艺术为基础的项目，作为招聘和留住人才的一种方式 否则可能会犹豫是否获得心理健康服务或承认自己的IPV的妇女。我们会 加强我们学术团体和社区团体之间的伙伴关系，建设所有人开展CBPR的能力 成员，并监督这一进程的成功。我们将适应、优先和试点测试评估 这些工具将被用来衡量我们干预的有效性。我们将试飞我们的 评估其可行性和可接受性并收集初步有效性数据的干预措施。此外，我们 将使社区参与设计和准备一项可接受的大规模干预研究。我们的 该项目在微观和宏观两个层面上都以赋权理论的原则为基础。在An上 在个人层面，我们的项目将使妇女能够解决她们关系中的暴力问题，使用自我管理 支持工具和自我护理实践，以控制他们的抑郁，并参与其中， 了解心理健康服务的消费者。在社区层面，该项目将使社区 成员与研究人员合作，设计和进行与其需求相关的研究，并 尊重他们的专业知识，使持久的资源留在适当的位置，并直接导致社会变革。

African-Americans receive less guideline-appropriate depression care than Whites. likewise, women with histories of intimate partner violence (IPV) have increased rates of depression and greater mistrust of mental health care. However, few mental health treatment programs specifically address the complex needs of African-American abuse survivors. We plan to use Community-Based Participatory Research (CBPR) to develop and test a community-based multi-faceted intervention to reduce depression disparities in AfricanAmerican women who have experienced IPV. The pUrPOse of this proposal is to strengthen our communityacademic partnership and to acquire the skills, tools, and preliminary data necessary to conduct a large-scale controlled trial. Our partnership consists of African-American IPV survivors, community leaders, domestic violence advocates, mental health providers and researchers who have already been working together to understand the beliefs and needs of depressed African-American IPV survivors. We are now developing a depression care model based within the Healing Roots Center, a community-based African-American domestic violence program. Our intervention incorporates many of the same principles included in the health systembased Chronic Care Model, but it places the community and its resources at the core of the program. AfricanAmerican domestic violence advocates will serve in a role similar to that of care managers, providing care coordination and patient education. They will link IPV survivors into the health care system and empower them to have more effective interactions with both on-site and clinic-based providers. Advocates will use motivational interviewing techniques to help women make behavior changes they wish to make in a culturallyappropriate manner. Finally, we will incorporate creative, arts-based programs as a way to recruit and retain women who might otherwise be hesitant to access mental health services or recognize their IPV. We will strengthen the partnership between our academic and community groups, build capacity for CBPR among all members, and monitor the success of the process. We will adapt, prioritize and pilot test assessment instruments that will be used to measure the effectiveness of our intervention. We will pilot test our intervention to assess its feasibility and acceptability and collect preliminary effectiveness data. Moreover, we will engage the community in designing and preparing an acceptable large-scale intervention study. Our project is strongly grounded in principles of Empowerment Theory on both micro and macro levels. On an individual level, our project will empower women to address the violence in their relationships, to use selfmanagement support tools and self-care practices to control their depression, and to become involved, informed consumers of mental health services. At a community level, the project will enable community members to partner with researchers to design and conduct research that is relevant to their needs and respectful of their expertise, which leaves lasting resources in place, and leads directly to social change.