RAND Corporation, Santa Monica, California, USA.
Ethn Dis. 2011 Summer;21(3 Suppl 1):S1-38-44.
Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioral therapy, in resource poor, ethnic minority, and/or disaster-affected communities with disparities in mental health. Community-academic participatory partnerships are a promising approach to addressing disparities by implementing community-appropriate, evidence-based depression care. A community-academic collaborative was formed in New Orleans after Hurricane Katrina to expand resources for effective depression care, including cognitive behavioral therapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioral therapy for depression in post-disaster community-based settings; 2) discuss the impact of this training program on therapist reported practice; and 3) share lessons learned regarding disseminating and sustaining evidence-based interventions in the context of a disaster impacted community. Using a mixed methods approach, we found that this model was feasible, acceptable, and disseminated knowledge about cognitive behavioral therapy in community settings. Over the course of two years, community providers demonstrated the feasibility of implementing evidence-based practice and potential for local community leadership. The lessons learned from this model of implementation may help address barriers to disseminating evidence-based interventions in other low-resource, disaster-impacted community settings.
在资源匮乏、少数民族和/或受灾社区中实施循证实践，如认知行为疗法，存在诸多挑战，这些社区在心理健康方面存在差异。社区-学术参与性伙伴关系是通过实施适合社区的、基于证据的抑郁护理来解决差异的一种有前途的方法。卡特里娜飓风后，新奥尔良成立了一个社区-学术合作组织，以扩大有效的抑郁护理资源，包括认知行为疗法。在本文中，我们：1）描述我们在灾后社区环境中提供抑郁认知行为疗法的能力建设模式；2）讨论该培训计划对治疗师报告的实践的影响；3）分享在受灾社区背景下传播和维持基于证据的干预措施的经验教训。使用混合方法，我们发现该模型是可行的、可接受的，并在社区环境中传播了认知行为疗法的知识。在两年的时间里，社区服务提供者展示了实施基于证据的实践的可行性和潜在的当地社区领导力。从这个实施模式中吸取的经验教训可能有助于解决在其他资源匮乏、受灾社区环境中传播基于证据的干预措施的障碍。
