School of Health Sciences, Faculty of Biology, Medicine & Health; University of Manchester, UK.
New Testament Church of God, Grey Services, Manchester, UK.
Ethn Dis. 2018 Sep 6;28(Suppl 2):485-492. doi: 10.18865/ed.28.S2.485. eCollection 2018.
To determine how to improve the cultural appropriateness and acceptability of an extant evidence-based model of family intervention (FI), a form of 'talking treatment,' for use with African Caribbean service users diagnosed with schizophrenia and their families.
Community partnered participatory research (CPPR) using four focus groups comprising 31 key stakeholders.
Community locations and National Health Service (NHS) mental health care settings in northwest England, UK.
African Caribbean service users (n=10), family members, caregivers and advocates (n=14) and health care professionals (n=7).
According to participants, components of the extant model of FI were valid but required additional items (such as racism and discrimination and different models of mental health and illness) to improve cultural appropriateness. Additionally, emphasis was placed on developing a new ethos of delivery, which participants called 'shared learning.' This approach explicitly acknowledges that power imbalances are likely to be magnified where delivery of interventions involves White therapists and Black clients. In this context, therapists' cultural competence was regarded as fundamental for successful therapeutic engagement and outcomes.
Despite being labelled 'hard-to-reach' by mainstream mental health services and under-represented in research, our experience suggests that, given the opportunity, members of the African Caribbean community were highly motivated to engage in all aspects of research. Participating in research related to schizophrenia, a highly stigmatized condition, suggests CPPR approaches might prove fruitful in developing interventions to address other health conditions that disproportionately affect members of this community.
确定如何提高现有的基于证据的家庭干预（FI）模式的文化适宜性和可接受性，这种模式是一种“谈话治疗”，适用于被诊断患有精神分裂症的非洲加勒比裔服务使用者及其家庭。
使用包括 31 名主要利益相关者在内的四个焦点小组进行社区合作参与式研究（CPPR）。
英国英格兰西北部的社区场所和国民保健制度（NHS）心理健康保健场所。
非洲加勒比裔服务使用者（n=10）、家庭成员、照顾者和倡导者（n=14）以及卫生保健专业人员（n=7）。
根据参与者的说法，FI 现有模式的组成部分是有效的，但需要增加一些内容（如种族主义和歧视以及不同的心理健康和疾病模式）以提高文化适宜性。此外，还强调要形成一种新的交付精神，参与者称之为“共享学习”。这种方法明确承认，在干预措施的提供涉及白种治疗师和黑种客户的情况下，权力失衡可能会加剧。在这种情况下，治疗师的文化能力被认为是成功进行治疗性接触和取得成果的基础。
尽管被主流心理健康服务机构贴上“难以接触”的标签，且在研究中代表性不足，但我们的经验表明，只要有机会，非洲加勒比社区的成员就非常有动力参与研究的各个方面。参与与精神分裂症相关的研究，这是一种高度污名化的疾病，这表明 CPPR 方法可能在开发针对这一社区成员受影响不成比例的其他健康状况的干预措施方面取得成效。
