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基于社区的参与式发展,培养社区卫生工作者发挥精神健康外展作用,以扩大卡特里娜飓风后的新奥尔良的合作式关怀。

Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans.

机构信息

Tulane University School of Medicine, Office of Community Affairs and Health Policy, USA.

出版信息

Ethn Dis. 2011 Summer;21(3 Suppl 1):S1-45-51.

Abstract

OBJECTIVES

The REACH NOLA Mental Health Infrastructure and Training Project (MHIT) aimed to reduce disparities in access to and quality of services for depression and posttraumatic stress disorder (PTSD) in post-Katrina New Orleans by developing a mental health outreach role for community health workers (CHWs) and case managers as a complement to the collaborative care model for depression treatment.

INTERVENTION

Community agency leaders, academics, healthcare organizations, and CHWs engaged in a community participatory process to develop a CHW training program.

DESIGN

A review of qualitative data including semi-structured interviews, project team conference calls, email strings, and meeting minutes was conducted to document CHW input into training and responses to implementation.

RESULTS

CHW contributions resulted in a training program focused on community engagement, depression screening, education, referral assistance, collaboration with clinical teams, and self-care. CHWs reported use of screening tools, early client successes in spite of challenges with client engagement, increase in networking and collaboration with other community agencies and providers, and ongoing community hurricane recovery issues.

CONCLUSIONS

This intervention development approach and model may be used to address post-disaster mental health disparities and as a complement to traditional implementation of collaborative care.

摘要

目的

REACH NOLA 心理健康基础设施和培训项目(MHIT)旨在通过为社区卫生工作者(CHW)和个案管理员开发心理健康外展角色,作为抑郁症协同护理模式的补充,来减少卡特里娜飓风后新奥尔良在获得和服务质量方面的抑郁和创伤后应激障碍(PTSD)的差异。

干预措施

社区机构领导、学者、医疗机构和 CHW 参与了社区参与式进程,以制定 CHW 培训计划。

设计

对定性数据进行了审查,包括半结构化访谈、项目团队电话会议、电子邮件和会议记录,以记录 CHW 对培训的投入和对实施的反应。

结果

CHW 的贡献促成了一个以社区参与、抑郁筛查、教育、转介协助、与临床团队合作和自我保健为重点的培训计划。CHW 报告了使用筛查工具,尽管在客户参与方面存在挑战,但客户早期取得成功,与其他社区机构和提供者的网络和合作增加,以及持续的社区飓风恢复问题。

结论

这种干预措施的开发方法和模式可用于解决灾后心理健康差距问题,并作为协同护理传统实施的补充。

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