Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 4, 2022
Date Accepted: Jul 26, 2022
PARTNER-MH, a peer-led patient navigation intervention for racial and ethnic minoritized veterans in Veterans Health Administration (VHA) mental health services: A mixed-methods randomized controlled feasibility trial study protocol
ABSTRACT
Background:
Mental healthcare disparities are persistent and have increased in recent years. Compared to their White counterparts, racial and ethnic minority groups have less access to mental healthcare. Minority groups also have lower engagement in mental health treatment and are more likely to experience ineffective patient-provider communication, which contribute to negative mental healthcare experiences and poor mental health outcomes. Interventions that embrace recovery-oriented practices to support patient engagement and empower patients to participate in their mental healthcare and treatment decisions may help to reduce mental healthcare disparities. Designed to achieve this goal, PARTNER-MH is a peer-led, patient navigation intervention that aims to engage minority patients in mental health treatment, support them to take a greater role in their care, and facilitate their participation in treatment shared decision-making.
Objective:
The primary aim of this study is to assess the feasibility and acceptability of PARTNER-MH delivered to patients over six months. The second aim is to evaluate the preliminary effects of PARTNER-MH on patient activation, patient engagement, and shared decision-making. The third aim to examine patient-perceived barriers and facilitators to engagement in PARTNER-MH, as well as contextual factors, using the Consolidated Framework for Implementation Research (CFIR), that may inhibit or promote the integration, sustainability and scalability of PARTNER-MH.
Methods:
This pilot study evaluates the feasibility and acceptability of PARTNER-MH in a VHA mental health setting using a mixed-methods, randomized controlled trial study design. PARTNER-MH is tested under real-world conditions, using certified VHA peer specialists (peers), selected via usual VHA hiring practices and assigned to the mental health service. The peers provide PARTNER-MH and usual peer support services. The study compares the impact of PARTNER-MH versus a wait-list control group on patient activation, patient engagement, and shared decision-making, as well as other patient-level outcomes. PARTNER-MH also examines organizational factors that could impact its future implementation in VHA settings.
Results:
Participants (N=50) were veterans who were mostly male (62%), self-identified as non-Hispanic Black (70%), with a median age in the 45-54 group. Most had at least some college education, and 32% completed 4 or more years of college. Randomization produced comparable groups in terms of characteristics and outcome measures at baseline, except for gender.
Conclusions:
Rather than simply documenting health disparities among vulnerable populations, PARTNER-MH offers opportunities to evaluate a tailored, culturally-sensitive system-based intervention to improve patient engagement and patient-provider communication in mental healthcare for racial and ethnic minorities. Clinical Trial: ClinicalTrials.gov NCT04515771; https://clinicaltrials.gov/ct2/show/NCT04515771
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.