Patient-centered care has become increasingly important over the past several decades, though the translation of these principles into clinical practices that customize care on an individual basis have been markedly inconsistent. This gap between principles and practices is especially evident in the context of public sector care for people with psychosis. As documented thoroughly in the Surgeon General's recent report Mental Health: Culture, Race, and Ethnicity (2001), the disenfranchisement of adults with psychosis is further accentuated among ethnic/racial minority communities in urban environments. The proposed study addresses these health disparities through qualitative and experimental evaluations of two complementary approaches to culturally responsive person-centered care for psychosis. The study has the following three specific aims: 1) to describe perceived barriers to, and benefits of, processes of help-seeking, participation in psychiatric care, and illness self-management efforts among low-income adults of color being treated for psychosis; 2) to evaluate the effectiveness of a facilitated approach to person-centered care with and without the augmentation of a community integration program in increasing customization of care over a 6 and 18-month period of outpatient treatment. Primary outcomes of person centered care are hypothesized to be increases in illness self-management and satisfaction with services, and secondary outcomes to be decreased symptoms and enhanced clinical and functional status and quality of life; and 3) to test a theoretical model that stipulates relationships between ethnic identity, community resources, and degree of cultural responsiveness and collaboration present in relationships between patients and outpatient mental health providers in mediating customization of care among an urban population of low-income adults of color. By identifying critical factors that promote effective patient-provider partnerships, this project enhances prospects for person-centered care and self-management of psychosis for low-income urban communities of color. If successful in the state of Connecticut, the project will offer a model that then can be replicated throughout the country to enhance care for this historically underserved population. ? ?
| Tondora, Janis; O'Connell, Maria; Miller, Rebecca et al. (2010) A clinical trial of peer-based culturally responsive person-centered care for psychosis for African Americans and Latinos. Clin Trials 7:368-79 |
