New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York, USA.
Implement Sci. 2011 Jul 26;6:80. doi: 10.1186/1748-5908-6-80.
This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI) and at risk for cardiovascular disease (CVD).
The proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30) to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention.
The proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population.
本研究描述了一种协作规划方法，融合了基于社区的参与性研究（CBPR）和干预映射的原则，以修改医疗保健经理干预措施，使其适用于新的患者群体和服务提供者群体，并评估这种修改后的干预措施改善患有严重精神疾病（SMI）和有心血管疾病（CVD）风险的西班牙裔人群身体健康的可行性和可接受性。
拟议的研究采用多阶段方法，应用 CBPR 原则和干预映射步骤——干预规划方法——从干预规划推进到试点测试。在第一阶段，将组建一个由研究人员和利益相关者组成的社区咨询委员会，以了解和审查干预措施并进行初步修改。第二阶段结合使用定性方法——患者焦点小组和利益相关者访谈——以确保所有利益相关者都接受这些修改。第三阶段利用第二阶段的结果进一步修改干预措施，制定实施计划，并对两名接受过修改后的干预措施培训的护理经理进行培训。第四阶段包括为期 12 个月的开放试点研究（N=30），以评估修改后的干预措施的可行性和可接受性，并探索其初步效果。最后，第五阶段包括分析试点研究数据并为未来的资金申请做准备，以更严格地评估修改后的干预措施。
本研究是迄今为止为数不多的专注于通过使用协作规划方法来增强有前途的医疗保健经理干预措施的可转移性和适用性，从而改善患有 SMI 和有 CVD 风险的西班牙裔人群身体健康的项目之一。本研究说明了如何融合健康差异研究和实施科学可以帮助减轻弱势群体中医疗疾病的不成比例负担。
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