Peer Navigation for Psychiatric Disabilities

(DRRRP-PHN Trial)

Not currently recruiting at 1 trial location

Overseen By Carla D Kundert, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Illinois Institute of Technology

Disqualifiers: Peer support, ACT services, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 8 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a Peer Navigator Program (PNP) helps adults with psychiatric disabilities improve their health and wellness. Participants will either receive regular integrated care or assistance from a peer navigator. Peer navigators, who have experienced similar challenges, guide participants through medical appointments and health goals. The trial seeks individuals with a serious mental illness living on Chicago's South Side who wish to improve their physical health with peer support. As an unphased trial, this study provides a unique opportunity for participants to contribute to innovative research that could enhance peer support systems for mental health.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on peer support and navigation rather than medication changes.

What prior data suggests that the Peer Navigator Program is safe for adults with psychiatric disabilities?

Research has shown that peer navigation, where individuals with similar experiences assist others with mental health challenges, is generally safe and well-received. In previous studies, peer navigators helped individuals increase their use of health services, which improved their health and quality of life. These studies did not identify any major safety issues or serious negative effects. This suggests that peer navigation is a safe and promising option for those considering similar programs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Peer Navigator Program (PNP) because it offers a personalized approach to managing psychiatric disabilities. Unlike traditional integrated care, which typically involves mental health and medical providers working together, the PNP involves peer navigators who meet participants in convenient locations to provide support tailored to individual needs. This includes help with scheduling and attending healthcare appointments, setting health-related goals, and taking actionable steps. The direct, personalized interaction aims to empower participants and improve engagement, potentially leading to better health outcomes.

What evidence suggests that the Peer Navigation program is effective for improving health and wellness in adults with psychiatric disabilities?

Research has shown that a peer navigator can greatly help people with psychiatric disabilities engage with services. In this trial, participants in the Peer Navigator Program (PNP) will receive support from peer navigators who have personal experience with similar challenges. Two small studies found that participants in a Peer Navigator Program experienced better health, recovery, and quality of life. Peer navigators assist patients in understanding the health system and setting and reaching health goals. This method was applied consistently and effectively. Overall, peer support has proven important and helpful for people with mental illnesses, improving both personal recovery and overall well-being. ^{1 6 7 8 9}

Who Is on the Research Team?

Patrick W Corrigan, PsyD

Principal Investigator

Illinois Institute of Technology

Are You a Good Fit for This Trial?

This trial is for adults over 18 with serious mental illness who want to improve their physical health and wellness. They must be active members of Thresholds in the Chicago South Side area, willing to attend sessions but not already receiving peer support or Assertive Community Treatment services.

Inclusion Criteria

I want to better my health and prevent illness with the help of a health guide.

Serious mental illness (as indicated by disability)

Willing to attend

Exclusion Criteria

I am currently getting support from a community mental health team.

Does not reside in the catchment area (Chicago South Side)

Not an active Thresholds member

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to either Treatment as Usual-Integrated Care (TAU-IC) or Peer Navigator Program (PNP) plus TAU-IC for 8 months

8 months

Visits as needed for healthcare appointments and goal-setting

Maintenance

Participants in the PNP intervention continue with a 4-month maintenance phase

4 months

Follow-up

Participants are monitored for outcomes such as service engagement, physical symptoms, and quality of life at 4, 8, and 12 months

4 months

Data collection at 4, 8, and 12 months

What Are the Treatments Tested in This Trial?

Interventions

• Integrated Care
• Peer Navigation

Trial Overview The study tests a Peer Navigator Program (PNP) against usual integrated care. PNP uses peers with similar backgrounds and recovery experiences to help participants navigate healthcare services. The goal is better engagement, health, recovery, and quality of life.

How Is the Trial Designed?

Group I: Peer Navigator Program (PNP) Experimental Treatment 1 Intervention

Peer navigators will meet individually and face-to-face with research participants in time and places convenient to the person as needed. Specific practices are determined by the research participant with the peer navigator and may include: * scheduling and attending healthcare appointments; * partnering with participant on tasks that arise from appointments; * health-related goal setting; and * taking action-steps toward health-related goals.

Group II: Treatment as Usual-Integrated Care (TAU-IC) Active Control 1 Intervention

Participants in this arm will receive integrated care from their usual provider, which is treatment as usual. Integrated care is mental health specialty and general medical care providers working together to address the physical and behavioral health care needs of patients. One-half of research participants will be randomized to integrated care alone.

Who Is Running the Clinical Trial?

Illinois Institute of Technology

Lead Sponsor

Trials

26

Recruited

15,300+

Arizona State University

Collaborator

Trials

311

Recruited

109,000+

Thresholds Inc.

Industry Sponsor

Trials

4

Recruited

810+

Published Research Related to This Trial

Latinos with serious mental illness face significant health disparities, experiencing illness and mortality at younger ages compared to other adults, highlighting urgent healthcare needs.

Community-based research identified key barriers such as insurance issues, language, and immigration concerns, and emphasized the potential of peer navigators to improve access to care and support for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Healthcare Needs of Latinos with Serious Mental Illness and the Potential of Peer Navigators. Corrigan, PW., Torres, A., Lara, JL., et al.[2023]

The Peer Navigator Program (PNP) significantly improved the scheduling and achievement of healthcare appointments for homeless African Americans with serious mental illness compared to treatment as usual (TAU) over a 12-month period.

Improvements in healthcare appointment utilization were particularly notable during the middle six months of the study, with benefits maintained in the final three months, highlighting the effectiveness of peer support in overcoming healthcare access barriers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer navigators to promote engagement of homeless African Americans with serious mental illness in primary care. Corrigan, PW., Pickett, S., Schmidt, A., et al.[2022]

The Bridge intervention, which involved peer health navigation for individuals with serious mental illness, led to significant improvements in health outcomes, including fewer pain and health symptoms after 6 months.

Participants in the Bridge group showed a marked shift in healthcare utilization, with a greater preference for primary care providers over emergency rooms, indicating a positive change in their approach to seeking medical care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot test of a peer navigator intervention for improving the health of individuals with serious mental illness. Kelly, E., Fulginiti, A., Pahwa, R., et al.[2022]

Peer navigator programs (PNP) can play a crucial role in reducing health disparities for ethnic minorities with serious mental illness, as highlighted by the perspectives of 15 service users and 5 peer navigators in a qualitative study.

Key factors for successful PNP include building trust and accessibility for service users, while peer navigators emphasized the need for quality supervision and support, particularly for undocumented Latinos.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Qualitative Evaluation of a Peer Navigator Program for Latinos with Serious Mental Illness. Sheehan, L., Torres, A., Lara, JL., et al.[2023]

The Our Peers-Empowerment and Navigational Supports (OP-ENS) program is a 12-month peer health navigator intervention designed specifically for Medicaid beneficiaries with physical disabilities in Chicago, aiming to improve access to healthcare services.

Developed through collaboration with disability rights leaders and healthcare researchers, OP-ENS utilizes a structured approach to identify barriers and set goals, demonstrating a community-directed method to address health disparities faced by people with disabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Our Peers-Empowerment and Navigational Support (OP-ENS): Development of a Peer Health Navigator Intervention to Support Medicaid Beneficiaries With Physical Disabilities. Magasi, S., Papadimitriou, C., Panko Reis, J., et al.[2021]

The pilot study tested a modified peer-health navigator intervention for individuals with serious mental illnesses, focusing on the use of an electronic personal health record, and involved 20 participants.

Results showed that using health navigators and personal health records led to improvements in health care access and self-management, indicating the intervention's feasibility and potential effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Electronic Health Records to Enhance a Peer Health Navigator Intervention: A Randomized Pilot Test for Individuals with Serious Mental Illness and Housing Instability. Kelly, EL., Braslow, JT., Brekke, JS.[2023]

The peer navigator program (PNP) significantly improved general health, psychological experience of physical health, recovery, and quality of life among 67 African American participants with serious mental illness compared to standard treatment over one year.

Participants in the PNP showed small to moderate effect sizes in health outcomes, indicating that peer support may enhance recovery and well-being, even as both groups experienced reductions in homelessness and increased insurance coverage.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Peer Navigators to Address the Integrated Health Care Needs of Homeless African Americans With Serious Mental Illness. Corrigan, PW., Kraus, DJ., Pickett, SA., et al.[2022]

The OP-ENS study demonstrated that peer navigators, who are trained individuals with disabilities, effectively improved health access for Medicaid beneficiaries by building trust and addressing social health concerns like poverty and discrimination.

The community-based participatory approach allowed peer navigators to refine the intervention based on their experiences, leading to a focus on social determinants of health and enhanced support for peers with mental health needs, highlighting the importance of consumer input in healthcare interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relationships at Work: Integrating the Perspectives of Disability Partners to Enhance a Peer Navigation Intervention. Herrman, D., Papadimitriou, C., Green, B., et al.[2022]

The Bridge intervention, a peer-led health navigator program, significantly reduced emergency room visits among 144 individuals with serious mental illnesses, showing its effectiveness in improving healthcare access.

While the intervention did not affect overall inpatient or outpatient service use, the reduction in emergency room visits suggests that it may help individuals manage their health more effectively and avoid crisis situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Service Use by Medicaid Recipients With Serious Mental Illness During an RCT of the Bridge Peer Health Navigator Intervention. Kelly, EL., Hong, B., Duan, L., et al.[2021]

People with serious mental illness have a significantly shorter life expectancy, dying up to 20 years younger than their peers, with people of color facing even greater disparities.

Peer health navigators (PHNs), who share similar backgrounds and experiences with patients, play a crucial role in helping individuals with serious mental illness navigate complex health systems, potentially improving their access to care and overall health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer Navigators for the Health Needs of People of Color With Serious Mental Illness. Corrigan, PW., Razzano, L., Pashka, N., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5371355/

Peer Navigators and Integrated Care to Address Ethnic ... This paper reviews research on peer navigators as to meet the integrated care needs of people with serious mental illness from minority ethnic groups.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10476060/

The effectiveness of peer support for individuals with mental ... Overall, results indicate that peer support is of clinical relevance for individuals with mental illness, and not limited to reinforcing personal recovery ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05018351

Peer Navigators for the Health and Wellness of People ... People with psychiatric disabilities who wish to improve their physical health/wellness and prevent disease through peer health navigation will be recruited ...

4. academic.oup.com academic.oup.com/tbm/article/13/9/710/7148295

Outcomes of a peer-led navigation program, PARTNER-MH ... The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary effectiveness of PARTNER-MH, a peer-led ...

5. jamanetwork.com jamanetwork.com/journals/jamapediatrics/fullarticle/2830100

Effectiveness of Patient Navigation During Transition to ... Results suggest that the navigator intervention may not reduce emergency department visits in this population.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11657732/

The role of navigation services in supporting mental health ... Navigation services have the potential to support MHA system transformation for enhanced transitions in care for TAY with MHA concerns and their families.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7225331/

Peer Support in Coordination of Physical Health and ... This study suggests that peer support specialists can uniquely contribute to the coordination of physical health and mental health services for individuals ...

8. pediatrics.jmir.org pediatrics.jmir.org/2024/1/e47545/

A Web-Based Peer-Patient Navigation Program ... Conclusions: Web-based patient navigation programs such as CONNECT may deliver peer support that can improve the quality and experience of care ...

9. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03321-z

A systematic review and meta-analysis of group peer support ... We conducted this systematic review and meta-analysis to determine the effectiveness of peer support for improving outcomes for people with ...