Improving Patient-provider Communication to Reduce Mental Health Disparities (CDA 16-153)
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Healthcare Disparities
- Sponsor
- VA Office of Research and Development
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Patient Activation Measure- Mental Health (PAM-MH)
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The purpose of this study is to develop a program to reduce mental health disparities for racial and ethnic minority Veterans. The research program is led by VA peer navigators who are trained specifically to deliver the study intervention. The specific aims of the program are to enhance navigation of mental health services, increase patient engagement, and improve patient-provider communication.
Study participants will be randomized into one of two study groups, which will determine when they receive the study intervention. Regardless of study group, participants will have the opportunity to receive services in addition to their regular mental health treatment (either immediately after enrollment into the study or after a 6-month waiting period).
Participants will be asked to complete study questionnaires at different timepoints throughout the study to assess their overall satisfaction with the study program and the mental health services that they receive. Participants will also complete an interview to discuss their experience in the study program.
Investigators
Eligibility Criteria
Inclusion Criteria
- •To be eligible:
- •Must be a Veteran belonging to a racial/ethnic minority group
- •Must be actively receiving mental health care in the Outpatient Mental Health Clinic at Veteran Health Indiana (Richard L. Roudebush VA Medical Center)
- •Must have started receiving mental health care as a new patient in the Outpatient Mental Health within 12 months prior to enrollment into the study
Exclusion Criteria
- •Not eligible if:
- •Is a Veteran not belonging to a racial/ethnic minority group
- •Not actively receiving mental health care in the Outpatient Mental Health Clinic at Veteran Health Indiana (Richard L. Roudebush VA Medical Center)
- •Started receiving mental health care as a new patient in the Outpatient Mental Health outside of the 12-month window
Outcomes
Primary Outcomes
Patient Activation Measure- Mental Health (PAM-MH)
Time Frame: Change from Baseline to 6 months
Measure Description: The PAM-MH is a 13-item questionnaire that measures an individual's perceived ability to manage illness and health behaviors. The questions are rated on a 4-point Likert-type scale (1= strongly disagree, 2=disagree, 3=agree, 4=strongly agree). Scores are then converted using Rasch analysis to a 100-point scale. Raw scores range from 13 to 52 and converted activation scores range from 0-100. Higher activation scores indicate higher level of patient activation.
Altarum Consumer Engagement (ACE) Change
Time Frame: Change from Baseline to 6 months
The ACE is administered as a 5-level Likert scale. The subscale scores range from 5 to 25, and the total engagement score is computed by adding the 3 subscale scores and multiplying the sum by 4/3 to obtain a possible range score of 20 to 100. Higher scores represent higher patient engagement.
SDM-Q9 PARTNER-MH
Time Frame: Change from Baseline to 6 months
The SDM-Q9 PARTNER-MH was adapted from Braddock et al.'s SDM-Q-9 informed decision-making scale. The original, validated scale, the SDM-Q-9, has 9 items measured on a 6-point Likert Scale, ranging from 0=completely disagree to 5=completely agree. The total score is calculated by summing the scores of the nine items, range from 0 to 45. A higher score indicates a greater level of perceived SDM.
Peer Coaching Experience Satisfaction Questionnaire
Time Frame: Administered after completion of the study program (6 months for Active PARTNER-MH )
Peer Coaching Experience Satisfaction Questionnaire is designed to collect feedback on a respondent's overall experience with a peer coach at the end of a 6-month period. Only participants in active PARTNER-MH were administered this questionnaire. This questionnaire was developed for the study. Question 1: Overall, how satisfied are you with PARTNER-MH program? Question 2: How satisfied are you with your assigned peer. Answers are rated on a Likert scale ranging from 1 (very satisfied) to 5 (very dissatisfied).
Trust and Satisfaction Survey Responses Change
Time Frame: Change from Baseline to 6 months
The Trust and Satisfaction Survey is a 5-item scale which assess a respondent's degree of trust toward the VA, VA mental health care services, and the study program. Respondents are asked to rate how much they agree with each of the 5 items. Items are rated on a scale ranging from 1 (strongly disagree) to 5 (strongly agree). The survey yields final scores ranging from 5 (minimum) to 25 (maximum) with higher scores representing greater trust and satisfaction. No subscale.
Secondary Outcomes
- Veteran's RAND 12-item Health Survey (VR-12) Change(Change from Baseline to 6 months)
- Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change(Change from Baseline to 6 months)
- Working Alliance Inventory Short-Revised (WAI-SR) Change(Change from Baseline to 6 months)
- UCLA Loneliness Scale (ULS-6) Change(Change from Baseline to 6 months)
- Patient Health Questionnaire (PHQ-9) Change(Change from Baseline to 6 months)