We propose to adapt and pilot test a new intervention to enhance provider assessment and response to sociocultural issues in the routine provision of psychosocial rehabilitation services (PRS) using the resources of the R-34 mechanism. Sociocultural issues play a large role in determining satisfaction and quality of life of consumers, especially for ethnic minority consumers. Developing a method to embed the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions for the diverse groups they encounter in everyday practice. Intervention development has been informed by our extensive clinical and research experience with culturally diverse consumers, the medical literature on changing provider practice using social cognitive theory to guide behavior change, and in- depth interviews with culturally diverse consumers and mental health providers. Our pilot data has shown that providers view assessment of culturally diverse consumers as a challenge and they do not routinely inquire about consumers' sociocultural issues. They expressed a need for training that applies across cultural groups and is not a cookbook of facts and statistics. This R-34 application has three specific aims: (1) To adapt an existing structured and culturally relevant Sociocultural Assessment Protocol (SCAP) for use in PRS. (2) To further develop a multifaceted intervention (APPRAISE) that is designed to: (i) enhance provider awareness of culture, (ii) train providers in using the SCAP, (iii) provide strategies for sustaining the use of the SCAP in agency practice. (3) To conduct a small randomized trial to assess the initial effectiveness of the APPRAISE intervention in changing provider behavior and to evaluate the uptake, feasibility, and acceptability of the intervention, as well as the sustainability of the use of the SCAP. A mixed-method approach will be applied to address our aims. Qualitative and quantitative techniques will be used to collect and analyze the data to further develop the SCAP and the APPRAISE Intervention. This research will provide preliminary evidence on whether providers demonstrate increased skill in assessing sociocultural issues after receiving the APPRAISE intervention, and whether these enhanced skills can be sustained. Given that our approach will elicit and value input from consumers and providers, this R-34 will advance the field by enhancing the cultural relevance of services and ultimately reducing disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness. This work will serve as the basis for an R01 to examine the impact of the use of the SCAP on consumer outcomes. ? ? ? ?
| Lee, Karen Kyeunghae; Yamada, Ann-Marie; Kim, Min Ah et al. (2015) Interdependent recovery of adults with schizophrenia: Asian American consumer perspectives of family involvement and influence. Psychiatr Rehabil J 38:273-5 |
| Yamada, Ann-Marie; Brekke, John S (2008) Addressing mental health disparities through clinical competence not just cultural competence: the need for assessment of sociocultural issues in the delivery of evidence-based psychosocial rehabilitation services. Clin Psychol Rev 28:1386-99 |
