Improve Primary Care Management of Adolescent Depression

描述(由申请人提供)：这份K23指导的以患者为导向的职业发展奖申请旨在为首席研究员提供从基于人群的流行病学和卫生服务研究过渡到卫生服务干预试验所需的教育和技能。主要研究人员的短期研究目标是收集必要的数据，以便为制定卫生系统干预措施提供信息，以改进对抑郁症的适当识别，并为初级保健环境中的抑郁症青少年启动及时的循证治疗。她的长期目标是获得在卫生服务干预领域成为一名有竞争力的研究人员所需的技能和经验，以改进初级保健环境中青少年精神健康状况的识别和适当治疗。为了帮助她实现这些目标，她确定了两位在青少年抑郁症和卫生服务干预方面具有互补专业知识的导师，以改善初级保健中的抑郁症治疗。本申请中概述的教育计划包括三个主题领域的授课和体验式培训：1)定性研究方法；2)儿童和青少年精神病理学和治疗；3)卫生服务干预设计、实施和评估。本申请中概述的三个项目建立在培训目标的基础上，并特别旨在：1)从人种学访谈中开发一个归纳模型，促进对青少年如何在初级保健环境中寻求和接受抑郁症治疗的了解；2)评估初级保健中持续抑郁的临床和人口预测因素，以便为将从干预中受益的青少年制定病例定义；3)确定基于慢性护理模型的卫生系统干预措施的可接受性和可行性，以改善对抑郁青少年的初级保健治疗。在完成这项K奖后，首席调查员将获得必要的技能和经验，以设计、获得资金和实施大规模卫生服务干预，以改善初级保健环境中青少年抑郁症的管理。

DESCRIPTION (provided by applicant): This K23 Mentored Patient-Oriented Career Development award application is designed to provide the education and skills necessary for the principal investigator to transition from population-based epidemiologic and health services research to health services intervention trials. The principal investigators' short-term research goal is to gather the data necessary to inform the development of a health system intervention to improve the appropriate identification of depression and the initiation of timely evidence-based treatments for depressed adolescents in primary care settings. Her long-term goal is to gain the skills and experience necessary to be a competitive researcher in the area of health services interventions to improve the identification and appropriate treatment of adolescent mental health conditions in primary care settings. To assist her in these goals, she has identified two mentors with complementary expertise in adolescent depression and health services interventions to improve the treatment of depression in primary care. The educational plan outlined in this application includes didactic and experiential training in three topic areas: 1) qualitative research methods; 2) child and adolescent psychopathology and treatment; and 3) health services intervention design, implementation and assessment. The three projects outlined in this application build on the training objectives and specifically aim: 1) to develop an inductive model from ethnographic interviews that promotes an understanding of how adolescents seek and receive treatment for depression in primary care settings, 2) to evaluate clinical and demographic predictors of depression persistence in primary care in order to develop a case definition for adolescent who would most benefit from an intervention, 3) to determine the acceptability and feasibility a health system intervention, based on the Chronic Care Model, to improve primary care treatment for depressed adolescents. At the completion of this K Award, the primary investigator will have obtained the skills and experience necessary to design, obtain funding for, and implement a large-scale health services intervention to improve the management of adolescent depression in primary care settings.