Mental Health Literacy Among Korean American Elders

描述(由申请人提供)：这项拟议的研究是为了应对旨在帮助减少精神健康差距的研究的高度需求而撰写的。调查的重点是增长最快、但研究不足、服务不足的少数族裔群体之一：韩裔美国长老。基于我们之前的研究发现，韩裔美国老年人的心理健康问题水平很高，但心理健康服务利用不足，拟议的研究将低心理健康素养概念化为服务利用不足的主要原因和干预努力的中心焦点。总体目标是更好地了解目标人群的心理健康素养水平，并制定/测试教育干预措施。拟议的研究包括三个阶段：(1)采用混合方法收集数据，包括调查和焦点小组；(2)制定教育干预计划；(3)试点测试和评估。将使用结构化问卷的调查数据来评估心理健康素养的水平，并确定心理健康素养的促进者和障碍。为了对心理健康素养提供更深入的评估，还将使用来自焦点群体的数据。后一项讨论将与韩裔美国老年人、他们的家庭成员、医疗保健专业人员和宗教领袖进行。各种精神健康问题和促进社区精神健康和服务利用的方法将成为不同视角的焦点。来自调查数据和焦点小组的调查结果将指导制定适合文化和可接受的教育干预计划。将编写一本韩语教育手册，目标是提高心理健康素养，并积极改变人们对精神障碍和服务利用的态度。我们还将采用同行主导的教育策略，培训业外同行领袖提供教育课程。这次会议不仅包括小册子，还包括同伴教育和小组讨论。以同行为基础的方法使人们对少数民族社区的独特特征有了更大的敏感性，在这些社区中，非正式领导人发挥着重要作用。在第三阶段，也就是最后阶段，将进行三种随机条件(对照、一般手册和同伴主导教育)的实验，以探索教育手册和同伴主导教育战略的有效性。我们假设：1)与对照组相比，治疗组(一般宣传册和同伴引导的教育)的患者对抑郁症的了解有所增加，对精神疾病和服务使用的态度发生了积极的变化；2)同伴引导的教育将比只使用宣传册的方法更有效。试点测试和评估将作为评估干预效果、干预规模和该方案在后续项目中实施的可行性的重要手段。我们还希望利用我们的发现制定一项适用于其他少数族裔群体的议定书。 公共卫生相关性：基于之前的研究结果，即韩裔美国老年人精神健康问题水平较高，但精神健康服务利用不足，拟议的研究将低精神健康素养概念化为服务利用不足的主要原因和干预努力的中心焦点。这项研究的总体目标是(1)更好地了解目标人群的心理健康素养水平，(2)制定/测试教育干预措施。

DESCRIPTION (provided by applicant): The proposed study is written in response to the heightened need for research designed to help reduce mental health disparities. The investigation focuses on one of the fastest growing but understudied and underserved ethnic minority groups: Korean American elders. Building upon our previous findings that Korean American older adults have high levels of mental health problems yet underutilize mental health services, the proposed study conceptualizes low mental health literacy as a major reason for service underutilization and a central focus of intervention efforts. The overall goals are to better understand the levels of mental health literacy manifest in the target population and to develop/test an educational intervention. The proposed study includes three phases: (1) data collection with a mixed methodology including a survey and focus groups; (2) development of an educational intervention program, and (3) pilot testing and evaluation. Survey data drawing on structured questionnaires will be used to assess the level of mental health literacy and to determine facilitators and barriers of mental health literacy. In order to provide a more in-depth assessment of mental health literacy, data from focus groups will also be used. The latter discussions will be conducted with Korean American older adults, their family members, health care professionals, and religious leaders. Various mental health issues and ways to promote community mental health and service utilization will serve as focal points for diverse perspectives. Findings from the survey data and focus groups will guide the development of a culturally appropriate and acceptable educational intervention program. An educational brochure in Korean will be written with the twin goals of increasing mental health literacy and making positive changes in attitudes toward mental disorders and service utilization. We will also adopt a peer-led education strategy where lay peer leaders are trained to deliver an educational session. The session includes not only the brochure but also peer-education and group discussion. The peer-based approach allows greater sensitivity to the unique characteristics of ethnic minority communities, where informal leaders play a significant role. During the third and final phase, an experiment with three randomized conditions (control, general brochure, and peer-led education) will be conducted to explore the effectiveness of the educational brochure and peer-led education strategy. We hypothesize that 1) those in the treatment groups (general brochure and peer-led education) would show increased knowledge of depression and positive changes in attitudes toward mental illness and service use compared to those in the control group, and 2) peer-led education would be more effective than the brochure-only approach. Pilot testing and evaluation will serve as an important means to assess effect size of intervention and feasibility of the program for implementation in a subsequent project. We also hope to use our findings to develop a protocol for application to other ethnic minority groups. Public Health Relevance: Building upon previous findings that Korean American older adults have high levels of mental health problems yet underutilize mental health services, the proposed study conceptualizes low mental health literacy as a major reason for service underutilization and a central focus of intervention efforts. The overall goals of the study are (1) to better understand the levels of mental health literacy manifest in the target population and (2) to develop/test an educational intervention.