Evaluation of a patient activation and empowerment intervention in mental health care.
BACKGROUND
Evidence suggests that minority populations have lower levels of attendance and retention in mental health care than non-Latino whites. Patient activation and empowerment interventions may be effective in increasing minority patients' attendance and retention.


OBJECTIVE
This study developed and evaluated a patient self-reported activation and empowerment strategy in mental health care.


METHODS
The Right Question Project-Mental Health (RQP-MH) trainings consisted of 3 individual sessions using a pre/post test comparison group design with patients from 2 community mental health clinics. The RQP-MH intervention taught participants to identify questions that would help them consider their role, process and reasons behind a decision; and empowerment strategies to better manage their care.


METHODS
A total of 231 participated, completing at least the pretest interview (n = 141 intervention site, 90 comparison site).


METHODS
Four main outcomes were linked to the intervention: changes in self-reported patient activation; changes in self-reported patient empowerment; treatment attendance; and retention in treatment.


RESULTS
Findings show that intervention participants were over twice as likely to be retained in treatment and over 3 times more likely than comparison participants to have scheduled at least 1 visit during the 6-month follow-up period. Similarly, intervention participants demonstrated 29% more attendance to scheduled visits than comparison patients. There was no evidence of an effect on self-reported patient empowerment, only on self-reported patient activation.


CONCLUSIONS
Results demonstrate the intervention's potential to increase self-reported patient activation, retention, and attendance in mental health care for minority populations. By facilitating patient-provider communication, the RQP-MH intervention may help minorities effectively participate in mental health care.
Alegría
Margarita
M
Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, Massachusetts, USA. malegria@charesearch.org
Polo
Antonio
A
Gao
Shan
S
Santana
Luz
L
Rothstein
Dan
D
Jimenez
Aida
A
Hunter
Mary Lyons
ML
Mendieta
Frances
F
Oddo
Vanessa
V
Normand
Sharon-Lise
SL
D000293:Adolescent; D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011209:Power, Psychological