UPR-CHA Research Center of Excellence: Making a Difference for Latino Health

描述（由申请人提供）：本申请涉及NCMHD竞争修订申请（NOT-MD-10-002）。它提供了一个机会，通过比较两种公共卫生方法来填补拉丁美洲人心理卫生保健比较有效性研究（CER）的知识空白。一种是通过电话提供，另一种是面对面的，包括简短的循证抑郁症治疗（6至8次），护理协调，积极的外展和系统的监测和监督。拟议的申请是由波多黎各大学（UPR）与剑桥健康联盟（CHA）通过其多元文化心理健康研究中心（CMMHR）合作提出的。它旨在扩大卓越综合研究中心（UPR-CHA RCE），以：1）进行CER，重点是为拉丁美洲人提供“诊所墙外”的基于证据的抑郁症护理;（2）将初级研究人员的比较有效性培训纳入 目前的P60活动;（3）在两个大型公共卫生系统建立CER数据基础设施;以及4） 开发工具（即手册）和方法（培训材料，如DVD），以传播核证的排减量结果和方法。目前正在进行的普遍定期审议-拉丁美洲和加勒比区域健康教育侧重于造成大陆和岛屿拉丁美洲人口之间健康差距的多种复杂因素。抑郁症是一种在少数民族和种族中非常普遍的慢性疾病，对医疗保健费用产生重大影响。拉丁美洲人在抑郁症治疗方面存在持久的差异，这一点可以从获得、参与和保留方面的问题中得到证明。患有抑郁症的拉丁裔人比非拉丁裔白人更不可能获得专业的心理健康服务，对于那些获得护理的人来说，早期辍学和错过后续预约的高比率仍然存在。我们提出的研究设计回应抑郁症的差异进入，参与和保留到抑郁症治疗拉丁美洲人。我们提出了一个两个网站的随机对照试验，以测试相结合的护理经理和简短的认知行为疗法（CBT）干预称为参与和咨询的拉丁美洲人，通过电话（ECLA-T），与相同的干预管理面对面（ECLA-F）相比，心理健康治疗在通常的初级保健为300拉丁美洲抑郁症患者参加初级保健诊所的比较有效性。

DESCRIPTION (provided by applicant): This application addresses NCMHD Competitive Revision Application (NOT-MD-10-002). It provides the opportunity to fill the knowledge gap of Comparative Effectiveness Research (CER) for mental health care for Latinos by comparing two public health approaches. One is offered by telephone and one face-to face, consisting of a brief evidence-based depression treatment (6 to 8 sessions), with care coordination, aggressive outreach and systematic monitoring and supervision. The proposed application is made by the University of Puerto Rico (UPR) in collaboration with Cambridge Health Alliance (CHA) through its Center for Multicultural Mental Health Research (CMMHR). It seeks to expand the Comprehensive Research Center of Excellence (UPR-CHA RCE) to: 1) conduct CER focusing on evidence based depression care given "outside the clinic walls" for Latinos; (2) incorporate training of junior investigators on comparative effectiveness into current P60 activities; (3) establish CER data infrastructure in two large public health systems; and 4) develop tools (i.e. manuals) and methods (training materials like DVDs) to disseminate CER findings and methodologies. The ongoing UPR-CHA RCE focuses on the multiple and complex factors contributing to health disparities among mainland and island Latino populations. Depression is a highly prevalent, chronic condition among ethnic and racial minorities with significant consequences for health care costs. There are enduring disparities in depression treatment for Latinos, as evidenced by problems In access, engagement and retention. Latinos with depression are less likely to access specialty mental health services than non- Latino whites and for those that do access care, early dropout and high rates of missed follow-up appointments persist. Our proposed research design responds to depression disparities in entry, engagement and retention into depression treatment for Latinos. We propose a two site randomized control trial to test the comparative effectiveness of a combined care manager and brief Cognitive Behavioral Therapy (CBT) intervention called Engagement and Counseling for Latinos, administered by telephone (ECLA-T), compared against the same intervention administered face to face (ECLA-F), and mental health treatment in usual primary care for 300 Latino depressed patients attending primary care clinics.