Clinical trial NCT06879093: Adaptation Plan for Culturally Competent Care (PAACI) in the Acute Psychiatric Unit.
Official title: Adaptation Plan for Culturally Competent Care (PAACI) in the Acute Psychiatric Unit.
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Mental Disorders
Cultural Competency
Psychiatric Hospitalization
Keywords: Cultural Competence
Mental Health Equity
Psychiatric Care
Immigrant Health
Acute Psychiatric Unit
Cross-Cultural Psychiatry
Health Disparities
Lead sponsor: Parc de Salut Mar
Sponsor class: OTHER
First posted: 2025-03-17
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: this study focuses on immigrant patients admitted to the acute psychiatric unit at hospital del mar. participants will be individuals aged 18 or older who experience acute mental health crises requiring hospitalization. the study will analyze clinical outcomes before and after the implementation of the paaci program, which aims to improve culturally competent psychiatric care.

Brief summary: This observational study aims to design, implement, and evaluate the Adaptation Plan for Culturally Competent Care (PAACI) in the Acute Psychiatric Unit of Parc de Salut Mar, Barcelona. The study focuses on improving healthcare quality for immigrant patients by reducing cultural and linguistic barriers in psychiatric care.

The PAACI program includes educational materials in multiple languages, enhanced collaboration with social services, training for healthcare professionals in cultural competence, and the use of interpretation devices. Key outcomes include reducing mechanical restraints, improving patient adherence to treatment, decreasing hospital readmissions, and increasing outpatient care engagement.

The study will analyze data from immigrant patients admitted to the Acute Psychiatric Unit one year before and after the implementation of PAACI, using various clinical and patient satisfaction indicators. This initiative aims to promote equal and equitable healthcare for diverse populations, potentially serving as a model for other mental health units.

Detailed description: This study evaluates the implementation of the Adaptation Plan for Culturally Competent Care (PAACI) in an Acute Psychiatric Unit. The project aims to improve psychiatric care for immigrant patients by addressing cultural and linguistic barriers.

The study follows an observational design, comparing key clinical outcomes before and after the PAACI implementation. It includes measures such as staff training in cultural competence, improved coordination with social and healthcare services, and the introduction of multilingual patient education materials.

The primary focus is on enhancing healthcare equity, reducing the use of mechanical restraints, improving patient adherence to outpatient care, and decreasing hospital readmissions. Findings from this study may inform future adaptations of culturally competent care models in psychiatric settings.

Eligibility criteria: Inclusion Criteria:

* immigrant patients admitted to the acute psychiatric unit
* age 18 or older
* hospitalization during the study period (12 months post-paaci implementation)

Exclusion Criteria:

* patients with severe cognitive impairment preventing informed consent
* individuals with acute medical conditions requiring transfer to another service
* refusal to participate or withdraw consent

Primary outcomes:
measure: reduction in mechanical restraints
timeFrame: 12 months after paaci implementation
Secondary outcomes:
measure: Hospital Readmission Rate Among Immigrant Patients
timeFrame: 12 months after paaci implementation
measure: Length of Hospital Stay for Immigrant Patients
timeFrame: 12 months after PAACI implementation
measure: Patient adherence to outpatient mental health services
timeFrame: 12 months after PAACI implementation
measure: patient and staff satisfaction levels
timeFrame: 12 months after paaci implementation
Other outcomes:
Locations:
city: Barcelona
country: Spain
facility: Hospital del Mar-Centro Forum
Study officials:
References:
citation: Elwell-Sutton TM, Jiang CQ, Zhang WS, Cheng KK, Lam TH, Leung GM, Schooling CM. Inequality and inequity in access to health care and treatment for chronic conditions in China: the Guangzhou Biobank Cohort Study. Health Policy Plan. 2013 Aug;28(5):467-79. doi: 10.1093/heapol/czs077. Epub 2012 Sep 16.
citation: Pereira ME, Alvaro Estramiana JL, Schweiger Gallo I. Essentialism and the expression of social stereotypes: a comparative study of Spain, Brasil and England. Span J Psychol. 2010 Nov;13(2):808-17. doi: 10.1017/s1138741600002468.
citation: Dein S. ABC of mental health. Mental health in a multiethnic society. BMJ. 1997 Aug 23;315(7106):473-6. doi: 10.1136/bmj.315.7106.473. No abstract available.
citation: Bhui K, Warfa N, Edonya P, McKenzie K, Bhugra D. Cultural competence in mental health care: a review of model evaluations. BMC Health Serv Res. 2007 Jan 31;7:15. doi: 10.1186/1472-6963-7-15.
citation: Betancourt TS, Newnham EA, Birman D, Lee R, Ellis BH, Layne CM. Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and U.S.-Origin Children. J Trauma Stress. 2017 Jun;30(3):209-218. doi: 10.1002/jts.22186. Epub 2017 Jun 6.