Community Navigators
- Conditions
- LonelinessSocial IsolationMental Health Issue
- Interventions
- Behavioral: Community Navigator InterventionOther: Control Group
- Registration Number
- NCT06594029
- Lead Sponsor
- Temple University
- Brief Summary
The Temple University Collaborative on Community Inclusion (TU Collaborative) is testing a community navigation intervention study based upon effective health navigation models by conducting a randomized controlled trial of the intervention to establish feasibility, efficacy, and outcomes among adults with serious mental illness (SMI).
- Detailed Description
The study is a randomized, controlled trial (RCT) that will examine the effectiveness of an intervention designed to support and enhance community participation for adults with serious mental illness (SMI) receiving community mental health services. The intervention is based on two evidence-based strategies. The first is the patient navigation interventions, which are used to assist people with SMI to identify and overcome barriers to accessing care. The second is the Capability, Opportunity, Motivation model of behavior change (COM-B model) which evaluates how each of these factors influences behavior. Participants will be assigned to one of two groups, the Community Navigator condition, or a control group. Those in the intervention arm will develop a community support plan with a peer support specialist community navigator and those in the control arm will receive printed information on the importance, skills, and opportunities for participation. Over the course of the 6-month intervention, participants in the intervention arm, with support from the peer support specialist will develop an initial participation plan, and through weekly meetings online or in-person will monitor their progress and make changes as needed. Recruitment will occur only in Philadelphia in collaboration with residential treatment service providers including: Merakey, Horizon House, COMHAR, Inc, and potential others. Data collection for all participants will take occur at baseline and at the end of the 6-month intervention. We aim to recruit and enroll 96 participants for a 16-month period in a randomized control trial of a community navigation intervention. Participants will be randomly assigned to either the intervention or an informational control group. The intervention group will meet with a peer support specialist once a week for 60-90 minutes. Enrollment will occur over 16 months, with 6 participants joining each month from behavioral health residential service sites. Each participant will have two meetings with a research assistant - an intake interview and an exit interview after 6 months. The primary analyses are expected months after the study initiation.
The aim of the research study is to determine the efficacy of a peer-support intervention to navigate community opportunities and resource to increase participation among adults with SMI and to determine if participation in the intervention increases social connections and decreases loneliness. The existing navigation approaches in health care have employed peer-delivered services and demonstrated significant effects. The program theory of this intervention is based on existing models of peer-delivered health navigation approaches.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 96
- meet the criteria for an SMI diagnosis of schizophrenia, schizoaffective, bipolar, or major depression diagnosis based on the MINI,
- are over the age of 18-years-old
- are fluent in English: As current intervention materials and research and intervention personnel are only fluent in English, only participants who can communicate in written and spoken English are eligible for enrollment.
- have a permanent residence without constraints on participation (free to come and go from residence without restrictions) 2
- have the ability to provide informed consent.
- inability to provide consent (legal guardian)
- unable to speak and understand English
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Community Navigator Intervention Community Navigator Intervention Weekly meetings between participant and a peer specialist. The peer specialist will help participants identify participation interests, set participation goals, and to achieve those goals while increasing confidence and competence in community participation. Initially, participants will develop a plan for community participation which includes a list of meaningful activities, identifying potential barriers and facilitators to participation. At each weekly meeting, the peer specialist will work with participants to determine what aspects of the plan are working and modify it based on any newly identified barriers, opportunities, or changes to the participants' interests or motivation. The sessions are designed to meet the participants where they are on their journey towards participating in the community. Each successive session will encourage growth and independence through peer support that is tailored to each participant's particular needs and ability. Active control group Control Group Receive information on community participation for adults with your health condition
- Primary Outcome Measures
Name Time Method Temple University Community Participation Scale (TUCP): baseline, and post-treatment after 6 months self-reports of community participation in 22 different areas including going to a supermarket, participating in a community social group (like a book club or recreational sports team), going to a movie, or working for pay. Participants are asked to indicate the number of days in the past 30 days that they participated in each of the 22 areas, whether each participation area was important to them, and whether they felt they participated in each area enough, not enough, or too much. Recent research has found the measure to be reliable and valid. An updated version of this measure is included which adds questions related to relationships with intimate partners and children and digital participation.
WHO Disability Assessment Schedule baseline, and post-treatment after 6 months measures each person's capability to participate. It assesses abilities in the areas of cognition, mobility, self-care, life activities, and participation. It contains 15-items.
- Secondary Outcome Measures
Name Time Method Clinical Assessment Interview for Negative Symptoms baseline, and post-treatment after 6 months assesses motivation and pleasure. It is a 13-item interview that asks questions about motivation for relationships, school and work, and recreation activities. It also measures the frequency of pleasurable social activities, school and work activities, and recreation activities.
Assessment Opportunity baseline, and post-treatment after 6 months will be done through a series of 12 questions that focus on both social and structural opportunities for participation. Social opportunities refer to having someone to go with and structural opportunities are related to environmental factors such as transportation, time, and resources.
The Social Embeddedness Scale baseline, and post-treatment after 6 months subscale of the social network questionnaire (Shaw et al., 2007) that is used to identify degrees of social contact. It contains six items focused on social contact (e.g., visits, conversations) with friends and family in the previous two weeks.
Interpersonal Mattering Scale (Moschella & Baynard, 2021; Elliott et al., 2004): baseline, and post-treatment after 6 months This 12-item scale examines three dimensions of mattering, including awareness ( α=.87), importance (α =.89), and reliance (α =.86).
3-Item UCLA Loneliness Scale (Hughes, Waite, Hawkley, & Cacioppo, 2004) baseline, and post-treatment after 6 months This brief measure of loneliness has shown satisfactory reliability and validity in the measurement of overall loneliness.
Lehman Quality of Life Interview (QLI) baseline, and post-treatment after 6 months assesses the overall quality of life of people with mental illness through an interview. There are 11 items that across three domains: community inclusion, holistic health and functioning, and human and legal rights. The statement "\[If homeless or in jail, the place where you typically sleep at night?\]" will be removed from Q5 the questionnaire as it is not relevant to our study participants.
Recovery Assessment Scale (RAS-20): baseline, and post-treatment after 6 months assesses self-determination and hope as it relates to recovery. It is frequently used as an outcome measure for program evaluations. It is a 20-item self-report measure. Items are scored on a 5-point Likert scale and range from strongly agree to strongly disagree
The MOS Social Support survey baseline, and post-treatment after 6 months A 19-item measure with 4 support scales (Emotional/Informational, Tangible, Affectionate, and Positive Social Interaction) and an overall functional social support index that has been shown to have good reliability and validity.