Testing the Right Question Project (RQP) Health Education Strategy in a Mental Health Setting
Condition: Diagnosis, Psychiatric
MeSH terms: Mental Disorders
Study type: Interventional

Summary: 
      The purpose of this pilot project is to test the effectiveness of three 20 minute health
      education modules on patient empowerment, patient activation and retention in care.
    

Detailed description: 
      Recent research has demonstrated positive outcomes for patients who take an active role in
      their mental health care (Linhorst & Eckert, 2003). Patients who participate in the
      decision-making process are more satisfied with services, have a greater sense of
      self-efficacy and confidence, an increased ability to cope with daily life, and are more
      likely to achieve their treatment goals (Linhorst & Eckert, 2003). As defined by Chamberlin
      and Schene (1997), empowerment in mental health care requires having access to information
      and resources, having a range of options from which to make choices, learning to think
      critically, and having the power to make decisions. Cooper-Patrick et al. (1999) indicate
      that minority patients are less likely to have a collaborative relationship with providers
      than are otherwise similar white patients. Thus, there is a need for minority patients to
      learn to take a more active role in their care. One way to address the need for increased
      empowerment and activation among minority mental health patients is to provide them with
      training to enhance their communication and decision-making skills. The Right Question
      Project (RQP) is a consumer educational technique designed for this purpose and developed for
      use in multiple settings. The proposed study will examine the effectiveness of RQP with a
      Latino population.

      The Right Question Project (RQP) is a non-profit organization that works primarily with low-
      and moderate-income communities with a history of disengagement from education, health care,
      and other social services. The RQP approach differs from traditional models of client
      empowerment in that instead of supplying clients with solutions to problems, the RQP gives
      them a means to develop their own solutions. RQP teaches clients to identify important
      issues, formulate questions, and devise plans to communicate and act in effective ways that
      address factors impacting their health. The RQP methodology involves:

        -  establishing a set of beliefs, principles, and values about client involvement;

        -  teaching a skill-building technique that helps clients to think critically and ask the
           "right" questions, leading to the answers they need; and

        -  giving clients a framework to create action plans and use their question-formulation
           skills.

      The RQP methodology is designed to build a permanent skill that clients can apply in health
      care, as well as in other contexts that involve self-advocacy (e.g., getting better child
      care). Thus far, implementation of the Right Question Project has shown that clients of any
      education or literacy level can easily participate and benefit from the methodology's
      three-step approach. RQP has been particularly successful in educational settings (Cohen,
      1995).

      The focus of the RQP health education module is to help patients learn how to formulate and
      ask questions of their health care providers, in order to improve the quality of their care.
      The Right Question Project, Inc. developed this protocol and trained staff at the Cambridge
      Health Alliance (CHA) to conduct health education modules with psychiatry outpatients. The
      pilot study uses a pre-post test design with two groups of 100 patients each from two clinics
      that serve primarily Latino patients. The group at the CHA clinic will serve as the
      "treatment" group. This group will receive the training modules and will be interviewed about
      their experience in care. The group at the clinic at Massachusetts General Hospital will
      serve as the "control" group. This group will be interviewed without first receiving the
      training. Outcomes for the groups will be compared to look for an effect. If the RQP training
      appears to have a positive affect on patients at CHA, then MGH patients will be offered the
      RQP training. By testing the effectiveness of this educational module, we hope to establish
      its usefulness as a means for the Cambridge Health Alliance to become even more
      patient-centered and to assist in the integration and institutionalization of patient
      empowerment/activation.
    

Intervention name(s): RQP patient health education module
Intervention type(s): Behavioral
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: decision-making; patient activation; empowerment; mental health; Depression; Anxiety; Other Psychiatric Disorder