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了解新旅程中的家庭参与和提供者外展的差异:一个针对首发精神病的协调专科护理计划。

Understanding differences in family engagement and provider outreach in New Journeys: A coordinated specialty care program for first episode psychosis.

机构信息

Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane WA, 99202, United States; Washington State Center of Excellence in Early Psychosis, WA, United States.

Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane WA, 99202, United States.

出版信息

Psychiatry Res. 2020 Sep;291:113286. doi: 10.1016/j.psychres.2020.113286. Epub 2020 Jul 10.

Abstract

The present study examined clinician outreach efforts to families and family engagement; and predictors of engagement in a coordinated specialty care (CSC) for first episode psychosis. From 2015 to 2019, 211 clients experiencing their first episode of psychosis and their family members received services from New Journeys, a network of CSC programs in the United States. Analyses examined the association between race/ethnicity, insurance type, referral source, housing stability, and outreach efforts and family attendance. Overall, 70% of client family members attended at least one psychoeducation appointment and in the first month of treatment 40% of family members attended family psychoeducation. Outreach efforts including phone attempts (β=1.09; p = 0.02) and phone contact (β=1.10; p = 0.02) were significantly higher for Black families relative to White families; whereas Black families were scheduled less often for a family psychoeducation (β=-0.28; p = 0.02) compared to Whites families. Significant differences in family attendance based on insurance type were also found (p<0.01). Referral source and housing stability were not significant predictors of outreach or attendance. These findings suggest that alternative engagement efforts that extend beyond in-person contact may be needed to continuously engage families, specifically Black families and those with public and no insurance.

摘要

本研究考察了临床医生对家庭的外展工作和家庭参与度;以及预测首次出现精神病的患者参与协调的专科护理(CSC)的因素。在 2015 年至 2019 年间,有 211 名首次出现精神病症状的患者及其家属接受了美国 CSC 项目网络“新旅程”(New Journeys)的服务。分析考察了种族/民族、保险类型、转介来源、住房稳定性以及外展工作与家庭参与度之间的关系。总体而言,70%的患者家属至少参加了一次心理教育预约,在治疗的第一个月,有 40%的家属参加了家庭心理教育。与白人家庭相比,黑人家庭的外展工作(包括电话尝试(β=1.09;p=0.02)和电话联系(β=1.10;p=0.02))显著增加;然而,与白人家庭相比,黑人家庭安排家庭心理教育的次数较少(β=-0.28;p=0.02)。基于保险类型的家庭参与度也存在显著差异(p<0.01)。转介来源和住房稳定性不是外展或参与度的显著预测因素。这些发现表明,可能需要超越面对面接触的替代参与努力来持续吸引家庭,特别是黑人家庭和那些拥有公共保险和无保险的家庭。

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