Abstract
BackgroundThis study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI) and at risk for cardiovascular disease (CVD).MethodsThe proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30) to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention.DiscussionThe proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population.
Highlights
This manuscript describes an innovative, collaborative intervention-planning approach that capitalizes on both researchers’ and stakeholders’ knowledge and skills to inform pre-implementation work to transport a promising healthcare manager intervention to a new patient population and provider group
This study will contribute to the advancement of implementation science by developing a collaborative approach that blends community-based participatory research (CBPR) principles and intervention mapping (IM) procedures for overcoming barriers to the modification, pre-implementation, and use of evidence-based approaches in real-world settings
This study’s strengths and innovations include [1] the testing of an innovative strategy for modifying interventions to vulnerable ethnic subgroups; [2] the preparation of an intervention for Hispanics with serious mental illness (SMI) that is urgently needed to address physical health disparities that have received limited attention; [3] the modification of a promising intervention to a different provider group that can improve access to preventive primary care, reduce risk for cardiovascular disease (CVD), and reduce premature mortality among Hispanics with SMI; and [4] the engagement of stakeholders in a collaborative effort to enhance the transportation of evidence-based interventions to underserved racial and ethnic minorities with SMI
Summary
This manuscript describes an innovative, collaborative intervention-planning approach that capitalizes on both researchers’ and stakeholders’ knowledge and skills to inform pre-implementation work to transport a promising healthcare manager intervention to a new patient population and provider group. This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI) and at risk for cardiovascular disease (CVD). Compared to non-Hispanic whites with SMI, Hispanics with SMI have higher rates of obesity [3], diabetes [4,5], and other metabolic risk factors[6,7], placing them at elevated risk for CVD These health needs are exacerbated by the fact that Hispanics with SMI and at risk for CVD are less likely to engage and receive high-quality medical care, even against the backdrop of the poorquality care received by people with SMI [8].
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