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Phases of Implementation and Modification to fit a Research Protocol and Design

Antonio Polo, PhD1, Margarita Alegria, PhD2, Norah Mulvaney-Day, PhD1, Jenna Sirkin1, and Devorath Ruiz1. (1) Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon St., Somerville, MA 02143, 617-503-8424, apolo@charesearch.org, (2) Psychiatry--Center for Multicultural MH Research, Harvard Medical School, 120 Beacon St., Somerville, MA 02143

Most translational approaches encourage the transfer of scientific research knowledge to community or “real-world” settings. However, these strategies rarely take advantage of existing community-generated expertise to develop clinical-research partnerships. This presentation illustrates the process of modifying and evaluating an existing educational strategy to test it in the context of a clinical trial targeting a mental health population.

The modifications of the original strategy, called the Right Question Project (RQP), were conducted in three phases. Phase 1 consisted of three pilot groups using the original methodology with an inpatient population. Qualitative and quantitative data was obtained to determine program modification needs. During Phase 2, measures were developed or identified which captured the main ingredients of change and the targeted population was refined (e.g. predominately ethnic minority and outpatient, regardless of diagnosis). Furthermore, the original strategy was changed to include three sessions in order to increase its “dosage” and monitor progress over time. Finally, during Phase 3, additional strategies for skill building and generalization were included (e.g. practice assignments and role-plays), a manualized protocol for delivery of each session was developed, and treatment fidelity was evaluated when delivered to mental health patients (via coded audiotaped sessions).

The adapted program's ability to impact patient self-efficacy, empowerment, and activation was evaluated using a quasi-experimental design. Over 175 patients participated and interviews were completed before the training and once after each subsequent training (4 total) at the intervention site. For the control site, participants were administered the questionnaire twice in the span of 8 weeks.

Learning Objectives:

Presenting author's disclosure statement:

Any relevant financial relationships? No

Moving a Consumer Empowerment Intervention into Practice

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA