社区参与式改编严重精神疾病患者心血管健康干预措施的过程。
A Community-Engaged Process for Adapting a Cardiovascular Health Intervention for Persons with Serious Mental Illness.
机构信息
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
出版信息
Ethn Dis. 2024 Apr 24;DECIPHeR(Spec Issue):27-34. doi: 10.18865/ed.DECIPHeR.27. eCollection 2023 Dec.
INTRODUCTION
People with serious mental illness experience grave disparities in cardiovascular disease risk factors. To promote scale-up of effective cardiovascular disease risk reduction interventions from clinical trials, it is important to involve end-users in adapting interventions to fit the needs of community-based settings.
OBJECTIVE
We describe a novel, theory-informed process of garnering community input to adapt IDEAL Goals, an evidence-based intervention for improving cardiovascular disease risk factors in persons with serious mental illness.
SETTING
Outpatient community mental health programs in Maryland and Michigan implementing behavioral health homes, which provide enhanced support to people living with both physical and mental illnesses.
PARTICIPANTS
Clinicians, frontline staff, and administrators from community mental health organizations and persons with serious mental illness.
METHODS
Our approach to community engagement is based on the Replicating Effective Programs (REP) framework. During the REP preimplementation phase, we used 2 community engagement activities: (1) a "needs assessment" to identify anticipated implementation barriers and facilitators, and (2) "community working groups" to collaboratively engage with end-users in adapting the intervention and implementation strategies.
MAIN FINDINGS
We used the Stakeholder Engagement Reporting Questionnaire to describe our processes for conducting a needs assessment, involving site-level surveys (N=26) and individual interviews (N=94), and convening a series of community working groups with clinicians and staff (mean, 24 per meeting) and persons with serious mental illness (mean, 8 per meeting).
CONCLUSIONS
By specifying the nature and extent of our community engagement activities, we aim to contribute to the evidence base of how to better integrate and measure community-engaged processes in the adaptation of evidence-based interventions.
简介
患有严重精神疾病的人在心血管疾病风险因素方面存在严重差异。为了将临床试验中有效的心血管疾病风险降低干预措施推广到更大规模，让最终用户参与到适应干预措施以满足基于社区的环境的需求非常重要。
目的
我们描述了一种新颖的、基于理论的过程，即从社区获取意见，以适应 IDEAL Goals，这是一项针对改善严重精神疾病患者心血管疾病风险因素的循证干预措施。
设置
马里兰州和密歇根州的社区心理健康计划实施行为健康之家，为患有身体和精神疾病的人提供增强的支持。
参与者
社区心理健康组织的临床医生、一线工作人员和管理人员以及严重精神疾病患者。
方法
我们的社区参与方法基于可复制有效项目（REP）框架。在 REP 实施前阶段，我们使用了 2 项社区参与活动：（1）“需求评估”，以确定预期的实施障碍和促进因素；（2）“社区工作组”，与最终用户合作，共同适应干预措施和实施策略。
主要发现
我们使用利益相关者参与报告问卷来描述我们进行需求评估的过程，包括现场调查（N=26）和个人访谈（N=94），以及与临床医生和工作人员（每次会议平均 24 人）和严重精神疾病患者（每次会议平均 8 人）举行一系列社区工作组会议。
结论
通过指定我们的社区参与活动的性质和范围，我们旨在为如何更好地将社区参与过程整合和衡量到循证干预措施的适应中提供证据基础。
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