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Blind Spots: Spatial analytics can identify nonrandom geographic variation in first episode psychosis program
Walter S Mathis1, Scott Woods1,2, Vinod Srihari1,2
1Yale University Department of Psychiatry.
Early Intervention in Psychiatry
|June 22, 2018
Summary
Spatial analytics revealed significant under-enrollment in first episode psychosis programs in specific geographic areas. These under-represented regions, despite having primary care providers, yielded no program participants, highlighting recruitment disparities.
Area of Science:
- Public Health
- Spatial Epidemiology
- Health Services Research
Background:
- First episode psychosis (FEP) programs aim for early intervention.
- Geographic variations in access and enrollment for FEP services are not well understood.
- Understanding spatial patterns is crucial for equitable service delivery.
Purpose of the Study:
- To identify geographic areas with significantly lower-than-expected enrollment in an FEP program.
- To analyze spatial disparities in FEP program recruitment relative to the at-risk population.
Main Methods:
- Applied spatial analytics, specifically adaptive bandwidth kernel smoothing, to estimate population density.
- Calculated a relative risk surface comparing FEP enrollee addresses to US Census data.
- Identified statistically significant under-represented areas (P < 0.05).
Main Results:
- Identified under-represented areas constituting 27.5% of the catchment area.
- These areas had 16% of the control population but zero FEP program participants.
- 179 primary care providers were located within these under-enrolled regions.
Conclusions:
- Demonstrated nonrandom spatial variation in FEP program enrollment.
- Findings highlight critical gaps in recruitment for specialty clinics.
- Further research should refine predictive models and assess recruitment intervention impacts.
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