Integrated Care & Patient Navigators for Latinos With Serious Mental Illness
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/14/2017 |
| Start Date: | August 2015 |
| End Date: | November 2016 |
The health care needs of people with serious mental illness are exacerbated by ethnic health
disparities. Latinos with serious mental illness show significant health problems compared to
other ethnic groups. Therefore, this project is to develop a meaningful peer-navigator
program for Latinos with serious mental illness using community-based participatory research
(CBPR). Investigators are currently working with seven Hispanic/Latinos with a mental illness
that have formed a Consumer Research Team (CRT) that will guide this project. This project
will identify and define the problem by conducting a mixed methods research thru qualitative
interviews with various stakeholders defined by the investigator's CRT group. The qualitative
findings will then be cross-validated in a quantitative survey by 100 Hispanic/Latinos with
mental illness. This information will then be used to design an intervention using an
integrated care model for Peer-Navigators. Feasibility, accessibility , acceptability and
impact of the peer-navigator program will be then evaluated in a randomized control trial
(RCT) with 100 Latinos with serious mental illness who will complete measures of physical
health, mental health, service use and engagement at baseline, 4, 8, and 12 months.
Investigators expect to show physical health improvement with the greater engagement observed
in the peer navigator group. Investigators expect a similar improvement in mental health and
quality of life as physical health concerns are diminished.
disparities. Latinos with serious mental illness show significant health problems compared to
other ethnic groups. Therefore, this project is to develop a meaningful peer-navigator
program for Latinos with serious mental illness using community-based participatory research
(CBPR). Investigators are currently working with seven Hispanic/Latinos with a mental illness
that have formed a Consumer Research Team (CRT) that will guide this project. This project
will identify and define the problem by conducting a mixed methods research thru qualitative
interviews with various stakeholders defined by the investigator's CRT group. The qualitative
findings will then be cross-validated in a quantitative survey by 100 Hispanic/Latinos with
mental illness. This information will then be used to design an intervention using an
integrated care model for Peer-Navigators. Feasibility, accessibility , acceptability and
impact of the peer-navigator program will be then evaluated in a randomized control trial
(RCT) with 100 Latinos with serious mental illness who will complete measures of physical
health, mental health, service use and engagement at baseline, 4, 8, and 12 months.
Investigators expect to show physical health improvement with the greater engagement observed
in the peer navigator group. Investigators expect a similar improvement in mental health and
quality of life as physical health concerns are diminished.
Latinos with serious mental illnesses have an inordinately high rate of physical illness
leading to a significantly shortened life. One reason is the difficulty in engaging this
disenfranchised group in primary care. Integrated services through community-based outreach
and care coordination are an innovative and evidence-based practice that improves physical
health. Unfortunately, social determinants of health for Latinos are often a barrier to
participation in integrated care. Peer navigators offer a strategy that might help members of
this group. Peer navigators, in this study, are Latinos with past history of serious mental
illness specially trained to help patients meet their health needs. The program will be
developed through community-based participatory research (CBPR) representing a hands-on
partnership between investigators and a community advisory board made up of patient partners.
Given this, investigators aim to do the following. (1) Develop a peer navigator program meant
to enhance the impact of already existing integrated services for Latinos with serious mental
illness. (2) Using an experimental design, test the impact of peer navigators, compared to
existing integrated services alone, on engagement of Latinos with serious mental illness in
primary care services. This includes indices of care seeking, appointments, and satisfaction
with engagement. Investigators expect these indices to be higher in the group with peer
navigators. (3) Determine the comparative impact of peer navigators versus
integrated-care-as-usual on subsequent health. Investigators expect to show physical health
improvement with the greater engagement observed in the peer navigator group. Investigators
expect a similar improvement in mental health and quality of life as physical health concerns
are diminished. This proposal represents the partnership between researchers from the Center
on Adherence and Self-Determination (a National Institute of Mental Health-funded Center
dedicated to understanding service engagement among people with serious mental illness and
their health care system) and Trilogy. Consistent with other projects, investigators will
develop a Community Advisory Board to conduct CBPR and complete a mixed-methods research
project to inform the peer navigator program. Based on a power-analysis, investigators will
recruit 100 Latinos with serious mental illness who will complete baseline measures of
physical health, mental health, service use and engagement in the previous year, quality of
life, and current housing/employment status. Patients will then be randomized to an existing
integrated care program for Hispanic/Latinos with mental illness with or without peer
navigators for one year. Measures will be repeated at 4, 8, and 12 months.
leading to a significantly shortened life. One reason is the difficulty in engaging this
disenfranchised group in primary care. Integrated services through community-based outreach
and care coordination are an innovative and evidence-based practice that improves physical
health. Unfortunately, social determinants of health for Latinos are often a barrier to
participation in integrated care. Peer navigators offer a strategy that might help members of
this group. Peer navigators, in this study, are Latinos with past history of serious mental
illness specially trained to help patients meet their health needs. The program will be
developed through community-based participatory research (CBPR) representing a hands-on
partnership between investigators and a community advisory board made up of patient partners.
Given this, investigators aim to do the following. (1) Develop a peer navigator program meant
to enhance the impact of already existing integrated services for Latinos with serious mental
illness. (2) Using an experimental design, test the impact of peer navigators, compared to
existing integrated services alone, on engagement of Latinos with serious mental illness in
primary care services. This includes indices of care seeking, appointments, and satisfaction
with engagement. Investigators expect these indices to be higher in the group with peer
navigators. (3) Determine the comparative impact of peer navigators versus
integrated-care-as-usual on subsequent health. Investigators expect to show physical health
improvement with the greater engagement observed in the peer navigator group. Investigators
expect a similar improvement in mental health and quality of life as physical health concerns
are diminished. This proposal represents the partnership between researchers from the Center
on Adherence and Self-Determination (a National Institute of Mental Health-funded Center
dedicated to understanding service engagement among people with serious mental illness and
their health care system) and Trilogy. Consistent with other projects, investigators will
develop a Community Advisory Board to conduct CBPR and complete a mixed-methods research
project to inform the peer navigator program. Based on a power-analysis, investigators will
recruit 100 Latinos with serious mental illness who will complete baseline measures of
physical health, mental health, service use and engagement in the previous year, quality of
life, and current housing/employment status. Patients will then be randomized to an existing
integrated care program for Hispanic/Latinos with mental illness with or without peer
navigators for one year. Measures will be repeated at 4, 8, and 12 months.
Inclusion Criteria:
- Identify ethnicity as Hispanic/Latino
- Identify with experience with a mental illness
Exclusion Criteria:
- Must be 18 years or older
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