Durbin Anna, Nisenbaum Rosane, Wang Ri, Hwang Stephen W, Kozloff Nicole, Stergiopoulos Vicky
MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Front Psychiatry. 2021 Nov 22;12:763396. doi: 10.3389/fpsyt.2021.763396. eCollection 2021.
Grounded in principles of adult education, Recovery Education Centres (RECs) hold promise in promoting recovery for adults with mental health challenges, but research on recovery outcomes for hard-to-reach populations participating in RECs is scant. This quasi-experimental study compares 12-month recovery outcomes of adults with histories of homelessness and mental health challenges enrolled in a REC, to those of participants of other community services for this population. This pre-post quasi-experimental study compared participants enrolled in a REC for people with histories of homelessness and mental health challenges ( = 92) to an age-and-gender frequency matched control group participating in usual services ( = 92) for this population in Toronto, Ontario. Changes from program enrollment to 12 months in personal empowerment (primary outcome), disease specific quality of life, recovery, health status, health related quality of life, and mastery were assessed. analyses compared subgroups with 1-13 h ( = 37) and 14+ h ( = 37) of REC participation during the study period to the control group. Linear mixed models estimated mean changes and differences in mean changes and 95% confidence intervals. Mean change in perceived empowerment from program enrollment to 12 months in the intervention group [0.10 (95% CI: 0.04, 0.15)] was not significantly different from the control group [0.05 (-0.01, 0.11)], mean difference, 0.05 [(-0.03, 0.13), = 0.25]. In the analysis, the mean change in perceived empowerment for the intervention subgroup with 14+ h of REC participation [0.18 (0.10, 0.26)] was significantly different than in the control group [0.05 (-0.01, 0.11)] mean difference, 0.13 [(0.03, 0.23), < 0.01]. Mean change in mastery was also significantly different for the intervention subgroup with 14+ h of REC participation [2.03 (1.04, 3.02)] vs. controls [0.60 (-0.15, 1.35)], mean difference, 1.43 [(0.19, 2.66), = 0.02]. There were no significant differences in other outcomes. With sufficient hours of participation, recovery education may be a helpful adjunct to health and social services for adults with mental health challenges transitioning from homelessness.
康复教育中心（RECs）基于成人教育原则，有望促进有心理健康问题的成年人康复，但针对参与康复教育中心的难以接触到的人群的康复效果研究却很少。这项准实验研究比较了有过无家可归经历和心理健康问题的成年人在康复教育中心接受12个月治疗后的康复效果，与该人群接受其他社区服务的参与者的效果。这项前后对照的准实验研究将参与针对有过无家可归经历和心理健康问题人群的康复教育中心的参与者（n = 92）与安大略省多伦多市该人群中参与常规服务的年龄和性别频率匹配的对照组（n = 92）进行了比较。评估了从项目登记到12个月期间个人赋权（主要结果）、特定疾病生活质量、康复、健康状况、健康相关生活质量和掌控感的变化。分析将研究期间参与康复教育中心1 - 13小时（n = 37）和14小时及以上（n = 37）的亚组与对照组进行了比较。线性混合模型估计了平均变化、平均变化差异和95%置信区间。干预组从项目登记到12个月期间感知到的赋权平均变化[0.10（95%置信区间：0.04，0.15）]与对照组[0.05（-0.01，0.11）]无显著差异，平均差异为0.05[（-0.03，0.13），p = 0.25]。在亚组分析中，参与康复教育中心14小时及以上的干预亚组的感知赋权平均变化[0.18（0.10，0.26）]与对照组[0.05（-0.01，0.11）]有显著差异，平均差异为0.13[（0.03，0.23），p < 0.01]。参与康复教育中心14小时及以上的干预亚组的掌控感平均变化[2.03（1.04，3.02）]与对照组[0.60（-0.15，1.35）]也有显著差异，平均差异为1.43[（0.19，2.66），p = 0.02]。其他结果无显著差异。有足够的参与时长时，康复教育对于从无家可归状态过渡过来且有心理健康问题的成年人的健康和社会服务可能是一种有益的辅助手段。
