推进心理健康和预防滥用药物的系统变革的实施和可持续性:定性研究
Ashlyn Burns1, Haleigh Kampman2, Lauren Magee3
1Department of Psychiatry, Indiana University School of Medicine, 410 West 10th Street, Indianapolis, IN, 46202, USA. ashbburn@iu.edu.
印第安纳州的区域预防系统 (RPS) 旨在通过解决社会决定因素来改善心理健康. 实施情况各不相同,耻辱和不信任构成了障碍,但社区基础设施和伙伴关系促进了进展.
科学领域:
- 公共卫生 公共卫生
- 卫生系统研究 卫生系统研究
- 心理健康干预 心理健康干预
背景情况:
- 健康的社会决定因素对心理健康有很大影响.
- 边缘化的人口面临更高的心理健康障碍率,由于耻辱和歧视.
- 系统变革倡议可以解决影响心理健康的上游社会决定因素.
研究的目的:
- 评估印第安纳州全州区域预防系统 (RPS) 的实施和可持续性.
- 在RPS实施过程中识别障碍物和促进者.
- 了解如何改变系统的举措可以促进心理健康和预防物质滥用.
主要方法:
- 使用半结构面试对9名区域协调员进行定性研究.
- 基于创新实施理论和实施研究综合框架的面试指南的开发.
- 使用先验编码框架对转录的采访进行分析.
主要成果:
- 实施面临诸如社区犹,不信任和围绕心理健康和物质滥用的耻辱等障碍.
- 促进者包括现有的社区基础设施和外部伙伴关系.
- 没有先前基础设施的农村社区经历了更长时间的实施,但重视了RPS支持和新的通信平台.
结论:
- 通过RPS的预防工作的实施和可持续性在不同社区有所不同.
- 优先考虑服务不足,接纳性社区的系统变革努力,可能比全州的方法更有效.
- 这一战略可以更好地解决与心理健康和药物滥用的社会决定因素相关的健康差异.
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