Implementing Patient-Centered Decision Support for Mental Health
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Mental Disorders
- Sponsor
- University of California, Los Angeles
- Enrollment
- 61
- Locations
- 1
- Primary Endpoint
- Days until using weight services
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
It is important that individuals with serious mental illness make informed choices among alternative healthcare treatments based on their preferences. However, at present, individuals' preferences are often not being elicited, nor used to guide which treatments are made available. In this pilot project, the investigators implement and evaluate a computerized method for assessing treatment preferences of individuals with schizophrenia. The investigators use weight management treatments for this initial test of the system. If this assessment method is found to predict treatment use and satisfaction, it can be used to guide implementation of treatments that improve outcomes while meeting individuals' preferences.
Detailed Description
Background/Rationale: It is important that individuals with serious mental illness have access to treatments that meet their preferences, and that they make informed choices among alternative treatments. Too often, preferences are not being routinely elicited, nor used to guide which treatments are made available. Schizophrenia is a serious mental illness that is common and produces substantial disability when poorly treated. National treatment guidelines specify that individuals with schizophrenia should receive evidence-based treatments that improve outcomes. For example, obesity is a pressing problem in this population, a side-effect of commonly used medications, and a cause of cardiovascular disease and premature mortality. There are multiple, different psychosocial interventions for weight management that can lead to reduced weight. None are widely used. If individuals' preferences were routinely assessed, then clinicians and managers would know when to make alternative treatments available. Objectives: This project implements and evaluates a method for routinely assessing the treatment preferences of individuals with schizophrenia. The objectives are to: 1) develop a computerized, kiosk-based system that delivers education regarding treatment options for weight, uses conjoint analysis to elicit preferences, and meets the cognitive needs of individuals with schizophrenia; 2) study the feasibility and acceptability of implementing this method at a mental health clinic; and, 3) evaluate the extent to which this method predicts use of evidence-based weight services, and satisfaction with services at three months. Methods: This is a prospective evaluation of preferences, treatment use, and satisfaction in individuals with schizophrenia. 94 individuals are enrolled who are overweight and receiving treatment at a busy, urban mental health clinic. These participants use a kiosk system that provides them with education about treatment options, and assesses their preferences regarding alternative treatments for weight. They are then offered a weekly, intensive, evidence-based psychosocial treatment for weight. Research assessments occur at baseline and 3 months. Treatment preferences are analyzed to determine how they relate to use of weight treatment, and satisfaction with treatment. Significance: People with serious mental illness could benefit from access to effective treatments. Implementing these treatments would be facilitated by routinely collecting information regarding individuals' preferences. If the assessment method in this study is found to be feasible, acceptable, and accurate, it could be used to support implementation of improved care at clinics, medical centers, and community-based programs.
Investigators
Alexander S. Young, MD MSHS
Professor
University of California, Los Angeles
Eligibility Criteria
Inclusion Criteria
- •diagnosis of schizophrenia
- •age 18 or older
- •Body Mass Index (BMI) of either 28.0-29.9 and gained 10 pounds in the last 3 months; OR, BMI of 30 or above
- •able to provide informed consent
Exclusion Criteria
- •a medical condition for which a weight program is contraindicated
- •pregnant and nursing mothers
- •attendance at a psychosocial intervention for weight management in the past month
- •individuals with legal conservators who manage informed consent
- •can not speak English
Outcomes
Primary Outcomes
Days until using weight services
Time Frame: 3 months
Utilization of the weight services offered. This includes the number of days until starting to use weight services. This is assessed using information regarding attendance at weight services, and by survey administered by interview.
Participant preferences regarding weight services
Time Frame: Baseline
Individuals' preferences are assessed regarding different attributes of weight treatments. These are assessed using computerized conjoint analysis methods.
Satisfaction with the weight services provided
Time Frame: 3 months
Satisfaction with the weight services provided. This is assessed using the Client Satisfaction Questionnaire administered by interview.
Number of weight services used
Time Frame: 3 months
Utilization of the weight services offered. This includes the number of weight service sessions attended. This is assessed using information regarding attendance at weight services, and by survey administered by interview.
Secondary Outcomes
- Feasibility and acceptability of implementing preference assessment(Baseline)