This RO1 is the expansion of the RQP pilot, conducted as part of the first UPR/CHA EXPORT grant. Pilot results showed that as patients practice strategies for obtaining information from providers, they become active participants in care and clarify expectations of treatment, thereby increasing patient-provider dialogue that allows for greater patient involvement and decision-making. The pilot study illustrated the promise of a simple and relatively low-cost intervention that is appropriate for low literacy populations.

This year RQP-MH has begun full implementation of a clinical trial in five sites, and data collection is currently underway. By conducting this patient intervention on a larger scale and pilot-testing a provider intervention component, we hope to provide evidence for an intervention that might improve patient engagement and retention in mental health care.

Aims of RQP II:

Aim 1: Conduct a randomized controlled trial to test a patient activation and self-management intervention for Latino and non-Latino white mental health patients, and assess the impact of the intervention on the following outcomes: perceived self-management, perceived activation, and engagement and retention in mental health care.
Aim 2: Investigate the relative effectiveness of adding a provider training component designed to increase receptivity to patient activation and self-management, using a quasi-experimental design.

This R01 aims to provide a comprehensive picture of the extent of substance disorder treatment disparities, the potential sources of intervention to remediate these disparities, and the social and economic burden associated with substance use disorders in minority populations. We intend to use the results of the study to supply service planners, policymakers, and service administrators with the best available data on the magnitude and sources of racial/ethnic disparities in alcohol and drug abuse treatment services, and information about the consequences of substance use disorders in ethnic and racial minority populations in the US.

The aims of Project 3 are:

Aim 1: Estimate and compare the level of unmet need for substance abuse treatment services by racial/ethnic group: Asians, Latinos, African Americans, and non-Latino whites.
Aim 2: Estimate the level of disparities between each racial/ethnic minority group (Asians, Latinos, and African Americans) and non-Latino whites in utilization of substance abuse treatment.
Aim 3: Preliminary work conducted for Aim 2 assists in the completion of Aim 3 as we will be using the same estimation models to identify mechanisms of disparities in substance abuse and alcohol treatment.

Drs. Norah Mulvaney-Day and Benjamin Cook have completed analyses and are currently drafting their results.

Under the P60 EXPORT grant, the University of Puerto Rico and Cambridge Health Alliance have collaborated in a mentoring process for junior investigators. The main goal is to establish an administrative structure that integrates and centralizes a synergistic core of researchers into a single interdisciplinary and trans-disciplinary research enterprise by pulling together resources, leadership, and expertise from the mainland United States and the island of Puerto Rico to conduct asthma and mental health disparities research in Latino communities.