Testing a Novel Community-based Occupational Therapy Model

Study Overview
=================
Brief Summary
-----------------
This study will perform a needs assessment within an outpatient mental health unit, deliver an occupational therapy model of care, track patient and organizational outcomes, and provide training to staff to implement the model.

Detailed Description
-----------------
In this project the investigators' overall objective is to implement a narrative medicine-based occupational therapy (OT) model of care that brings client voices to the forefront of treatment planning and intervention to enhance the existing interdisciplinary system of service delivery within Midtown Community Mental Health (MCMH). The investigators hope to accomplish this objective via the following specific aims:1) Assess current programming - particularly processes surrounding client assessment, treatment planning, intervention, care-coordination/residential placement, and discharge - within MCMH sites to better understand limitations/gaps previously identified by the site manager that impact equitable and effective treatment 2) Adapt an existing care model - the Art of Healing Wellness Model (AoHW) - to meet the needs of MCMH, implement the model using an OT practitioner, and track feasibility/acceptability outcomes. 3) Re-assess MCMH programming post implementation to identify/demonstrate change resulting from the model 4) Using OT in the role of consultant, offer training to current MCMH staff to enable implementation of the adapted AoHW by MCMH (baccalaureate level) care coordinators 5) Preliminarily evaluate usability of the adapted AoHW by MCMH staff via focus groups following training and staff implementation

Official Title
-----------------
Improving Equitable Care With Narrative Medicine and a Novel Community-based Occupational Therapy Care Model

Conditions
-----------------
Mental Disorders, Severe

Intervention / Treatment
-----------------
* Behavioral: Occupational Therapy
* Behavioral: Case management; psychological services


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria • Patient on a pre-determined treatment team at the outpatient mental health recruitment site Exclusion Criteria Under 18 Pregnant

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Experimental Occupational Therapy services | Behavioral: Occupational Therapy<br>* Detailed narrative assessment and person-centered participation in meaningful activities<br>|
| Active Comparator: Comparison group<br>Treatment as usual | Behavioral: Case management; psychological services<br>* Weekly consultation with case managers to address housing and therapy needs<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Occupational Circumstances Assessment Interview & Rating Scale (OCAIRS) | The Occupational Circumstances Assessment Interview and Rating Scale is a semi-structured interview that measures a person's current participation in life in 12 areas:roles, habits, personal causation, values, interests, skills, short-term goals, long-term goals, interpretation of past experiences, physical environment, social environment, & readiness for change. The assessment provides an overall quantitative summed score of participation ranging from 12 to 48 with a higher number indicating greater participation as well as individual scores of 1-4 for each subsection. | 12 weeks |