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Researching the effectiveness of a decision-support tool for adult consumers with mental health needs and their care managers
Investigator (PI): Chu, Joyce
Past Investigator: Pais, Shobha; Van Buren, Erika
Performing Organization (PO): (Current): Felton Institute / (415) 474-7310
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2013
Final Year: 2018
Record Source/Award ID: PCORI/CE-12-11-4309
Funding: Total Award Amount: $1,455,544
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: The primary goal of the proposed study is to investigate the implementation and effectiveness of the M-POWR (Managing Patient-centered Outcomes through Wellness and Recovery) system in diverse urban and rural community mental health settings. The study will compare patient participation and outcomes using the M-POWR system to a usual care control condition. Four community mental health agencies will participate in the research: two in San Francisco (urban) and two in rural New Mexico. One site in each setting will serve as the M-POWR implementation site, and the other will serve as the control site. A cluster randomized trial design will be used; service sites will be randomly assigned to intervention or usual care conditions. The study design will employ repeated quantitative measures to assess change in outcomes within and across conditions over time. Qualitative methods in the form of focus group interviews will also be used to round out the information obtained about patient and provider expectations and experiences. Outcomes of interest include patient engagement in mental health services and shared decision making; quality of life; community living skills; access to community/social services; patient understanding and use of services options; satisfaction with the provider-patient relationship; personal progress in goal attainment; and patient functionality. The specific aims of this study are (1) to improve patient and provider participation in shared decision making and engagement in mental health treatment, to improve patient personal quality of life and to improve patient access to community/social services; (2) to increase patient understanding of their treatment and of treatment options; to increase their personal treatment progress; and (3) to increase patient functionality and sense of perceived support for their therapeutic outcomes. It is hypothesized that use of the M-POWR will yield significant increases in the outcomes identified within each of the above research questions, and the null hypothesis of no difference between groups receiving intervention and groups receiving usual care will be tested. A generalized estimating equation (GEE) analytic approach will be employed to test comparisons across groups. The results stand to validate the use of consumer feedback and shared decision making with care managers of mental health services, thereby extending the reach and benefit of these evidence-based strategies to a much broader, more diverse patient population with chronic needs. The results also stand to validate and reinforce the use of assessment instruments that identify life domains that are meaningful for consumers, including quality of life and community living skills, in improving patient engagement and goal attainment. Finally, the results hold potential to demonstrate the savings from employing a relatively low-cost system that is expected to help consumers and providers identify and achieve service goals in less time.
MeSH Terms:
  • Adult
  • Decision Making
  • * Decision Support Techniques
  • Focus Groups
  • Health Care Costs
  • * Health Services Accessibility
  • Humans
  • Mental Disorders /diagnosis
  • /*therapy
  • Mental Health Services /economics
  • /*organization & administration
  • New Mexico
  • Outcome Assessment, Health Care
  • * Patient Participation
  • Patient Satisfaction
  • Professional-Patient Relations
  • Quality of Life
  • Rural Population
  • San Francisco
  • Urban Population
Country: United States
State: California
Zip Code: 94109
UI: 20143042
CTgovId: NCT02761733
Project Status: Completed
Record History: ('2018: Project extended to 2018. 2017: Project extended to 2017 and PI changed to Chu.',) ('CHANGED PI from Van Buren to Pais, CHANGED PO name (Felton Institute was previously called Family Service Agency of San Francisco), 8/4/2015. ',)