Evaluation of a patient activation and empowerment intervention in mental health care

被引:181
作者
Alegria, Margarita [1 ,2 ]
Polo, Antonio [4 ]
Gao, Shan [1 ]
Santana, Luz [5 ]
Rothstein, Dan [5 ]
Jimenez, Aida [1 ]
Hunter, Mary Lyons [6 ]
Mendieta, Frances [1 ]
Oddo, Vanessa [1 ]
Normand, Sharon-Lise [3 ]
机构
[1] Cambridge Hlth Alliance, Ctr Multicultural Mental Hlth Res, Somerville, MA 02143 USA
[2] Harvard Univ, Sch Med, Dept Psychiat, Somerville, MA USA
[3] Harvard Univ, Sch Med, Dept Hlth Care Policy, Somerville, MA USA
[4] De Paul Univ, Dept Psychol, Chicago, IL 60614 USA
[5] Right Quest Project Inc, Cambridge, MA USA
[6] Massachusetts Gen Hosp, Chelsea Healthcare Ctr, Chelsea, MA USA
关键词
retention; attendance; mental health; patient activation; ethnic minorities;
D O I
10.1097/MLR.0b013e318158af52
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Evidence suggests that minority populations have lower levels of attendance and retention in mental health care than non-Latino whites. Patient activation and empowerment interventions may be effective in increasing minority patients' attendance and retention. Objectives: This study developed and evaluated a patient self-reported activation and empowerment strategy in mental health care. Research Design: The Right Question Project-Mental Health (RQP-MH) trainings consisted of 3 individual sessions using a pre/post test comparison group design with patients from 2 community mental health clinics. The RQP-MH intervention taught participants to identify questions that would help them consider their role, process and reasons behind a decision; and empowerment strategies to better manage their care. Subjects: A total of 231 participated, completing at least the pretest inter-view (n = 141 intervention site, 90 comparison site). Measures: Four main outcomes were linked to the intervention: changes in self-reported patient activation; changes in self-reported patient empowerment; treatment attendance; and retention in treatment. Results: Findings show that intervention participants were over twice as likely to be retained in treatment and over 3 times more likely than comparison participants to have scheduled at least I visit during the 6-month follow-up period. Similarly, intervention participants demonstrated 29% more attendance to scheduled visits than comparison patients. There was no evidence of an effect on self-reported patient empowerment, only on self-reported patient activation. Conclusions: Results demonstrate the intervention's potential to increase self-reported patient activation, retention, and attendance in mental health care for minority populations. By facilitating patient-provider communication, the RQP-MH intervention may help minorities effectively participate in mental health care.
引用
收藏
页码:247 / 256
页数:10
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