A community intervention to promote evidence-based mental health care for olderadults with depressive and anxiety symptoms.

项目概要/摘要 这是奥斯卡·弗洛雷斯-弗洛雷斯，医学博士，理学硕士的K43福格蒂新兴全球领导者奖的申请。 博士弗洛雷斯-弗洛雷斯作为一名年轻的研究人员表现出了很大的希望，并在以下方面进行研究的经验： 低收入和中等收入国家（LMIC）的老龄化和慢性病流行病学。但他 现在建议获得实施科学方面的专业知识，需要额外的培训和指导， 帐号吧.他的总体职业目标是成为一名独立调查员，实施证据- 为老年人提供心理健康护理干预，该奖项将为弗洛雷斯-弗洛雷斯博士提供 支持和培训，以实现这一目标。他组建了一个经验丰富的导师团队，包括： 博士Jose Parodi [Primary LMIC Mentor，geriatrics & public health，Associate Professor（USMP）]; Prof. Joseph Gallo [美国初级导师，混合方法研究，教授（JHSPH）]; Marina Piazza教授[共同导师， 实施科学，教授（UPCH）];和威廉·查克利博士[共同导师，混合有效性- 实施研究设计，副教授（JHSPH）]。通过密切的指导， 实践经验和关键课程，弗洛雷斯-弗洛雷斯博士建议完成以下培训 目标：1）实施科学培训; 2）实验研究设计培训; 3）高级 混合方法研究培训; 2） 抑郁和焦虑症状在老年人中非常普遍，并且经常一起出现。 有循证护理可以减少老年人的抑郁和焦虑症状。跨诊断 解决问题疗法（PST）等方法已被证明是有效的， 这是世界卫生组织（WHO）推荐的。然而，要获得这些信息， 老年人的精神卫生保健。因此，系统和有效地针对这些障碍的干预措施 是迫切需要的。弗洛雷斯-弗洛雷斯博士建议调整、测试和完善多方面的干预策略 为秘鲁利马资源匮乏地区的老年人提供精神卫生保健。他建议确定 通过社区卫生工作者提供精神卫生保健是否会有高吸收率， 老年人的抑郁和焦虑症状。这项研究的结果将产生初步数据， 竞争R 01级别的奖项，在多个地区进行大型集群实施有效性试验 社区，并确定干预措施对抑郁/焦虑症状和其他健康的影响- 相关成果。

PROJECT SUMMARY/ABSTRACT This is an application to the K43 Fogarty Emerging Global Leader Award for Oscar Flores-Flores, MD, MSc. Dr. Flores-Flores has shown great promise as a young investigator and has experience conducting research in the epidemiology of aging and chronic diseases in low- and middle-income countries (LMICs). However, he is now proposing to gain expertise in implementation science and requires additional training and mentorship to do so. His overall career goal is to become an independent investigator in the implementation of evidence- based mental health care interventions for older adults, and this award will provide Dr. Flores-Flores with the support and training to accomplish this goal. He has assembled an experienced mentorship team including: Dr. Jose Parodi [Primary LMIC Mentor, geriatrics & public health, Associate Professor (USMP)]; Prof. Joseph Gallo [Primary U.S Mentor, mixed methods research, Professor (JHSPH)]; Prof. Marina Piazza [Co- Mentor, Implementation Science, Professor (UPCH)]; and Dr. William Checkley [Co-Mentor, hybrid effectiveness- implementation study Designs, Associate Professor (JHSPH)]. Through a combination of close mentorship, practical experience and key coursework, Dr. Flores-Flores proposes to accomplish the following training goals: 1) training in implementation science; 2) training in experimental study designs; and 3) advanced training in mixed-methods research; 2) Depression and anxiety symptoms are highly prevalent in older adults, and often present together. Evidence-based care exists to reduce depression and anxiety symptoms in older age. Trans-diagnostic approaches such as problem-solving therapy (PST) have been shown to be effective and have been recommended by the World Health Organization (WHO). However, there are myriad barriers to accessing mental health care in older adults. Thus, interventions that systematically and effectively target those barriers are urgently needed. Dr. Flores-Flores proposes to adapt, test, and refine a multi-faceted intervention strategy to deliver mental health care to older adults in low resource settings in Lima, Peru. He proposed to determine whether delivering mental health care via community health workers will have high uptake and will improve symptoms of depression and anxiety in older adults. Results from this study will generate preliminary data to compete for an R01-level award to conduct a large cluster implementation-effectiveness trial in multiple communities and determine the effect of the intervention on depressive/anxiety symptoms and other health- related outcomes.