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通过同伴提供的决策支持促进早期精神病患者的治疗参与:干预措施开发及试点评估方案

Facilitating treatment engagement for early psychosis through peer-delivered decision support: intervention development and protocol for pilot evaluation.

作者信息

Thomas Elizabeth C, Suarez John, Lucksted Alicia, Siminoff Laura A, Hurford Irene, Dixon Lisa B, O'Connell Maria, Penn David L, Salzer Mark S

机构信息

Temple University College of Public Health, 1700 N Broad Street, Philadelphia, PA, 19121, USA.

University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, 21201, USA.

出版信息

Pilot Feasibility Stud. 2021 Oct 24;7(1):189. doi: 10.1186/s40814-021-00927-8.

Abstract

BACKGROUND

Emerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact.

METHODS

The intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engagement in the program) will also be assessed. Additionally, through observation and feedback from the peer decision coach and study participants, we will evaluate the feasibility of research and intervention procedures, and the acceptability of information and support from the peer decision coach.

DISCUSSION

The peer-delivered decision coaching intervention holds promise for assisting young people with making informed and values-consistent decisions about their care, and potentially enhancing service engagement within this traditionally difficult-to-engage population. If the intervention demonstrates feasibility and acceptability, and pilot data show its potential for improving treatment decision-making, our work will also lay the foundation for a new evidence base regarding roles for peer specialists on early intervention teams.

TRIAL REGISTRATION

This trial was registered with ClinicalTrials.gov (Identifier: NCT04532034 ) on 28 August 2020 as Temple University Protocol Record 261047, Facilitating Engagement in Evidence-Based Treatment for Early Psychosis.

摘要

背景

患有早期精神病的新兴成年人表现出较高的脱离关键早期干预服务的比率。决策支持干预和同伴支持都已被证明可提高服务参与度,但在这一人群中尚未得到充分研究。本文的目的是描述一种针对该人群的新型同伴提供的决策指导干预措施的开发,并报告一项试点研究的计划,该研究旨在收集有关其可行性、可接受性和潜在影响的初步数据。

方法

该干预措施是根据形成性定性数据并与不同的研究团队、关键利益相关者和专家顾问合作开发的。试点试验将采用单组(N = 20)、前后对照、收敛性混合方法设计,以探索该干预措施是否以及如何满足决策需求(主要干预目标)。还将评估该干预措施对次要结果(例如参与该计划)的影响。此外,通过同伴决策教练和研究参与者的观察与反馈,我们将评估研究和干预程序的可行性,以及同伴决策教练提供的信息和支持的可接受性。

讨论

同伴提供的决策指导干预措施有望帮助年轻人就其护理做出明智且符合价值观的决策,并有可能提高这一传统上难以参与服务的人群的服务参与度。如果该干预措施证明可行且可接受,并且试点数据显示其具有改善治疗决策的潜力,我们的工作还将为有关同伴专家在早期干预团队中的作用的新证据基础奠定基础。

试验注册

该试验于2020年8月28日在ClinicalTrials.gov(标识符:NCT04532034)上注册,作为天普大学协议记录261047,促进早期精神病的循证治疗参与。

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