Optimizing Family Involvement in Late-Life Depression Care

简介(申请人提供)：詹妮弗·L·沃尔夫博士是约翰霍普金斯大学布隆伯格公共卫生学院的助理教授，曾接受老年学、健康服务和结果研究方面的培训。这项拟议的NIMH导师研究科学家职业发展奖(K01)将提供必要的支持，以促进沃尔夫博士成功地过渡到老年精神健康服务干预研究领域的独立研究员。沃尔夫博士的最终目标是开发一个研究项目，以优化家庭在晚年抑郁症护理过程中的参与，并通过这样做，促进患有抑郁症的老年人的心理健康和生活质量的改善。拟议的培训计划包括一系列学习活动，以增加候选人对晚年抑郁症、其治疗和抑郁症护理提供模式的知识，以及发展健康教育和沟通研究以及进行临床试验的新技能。在这些学习活动的基础上，将在整个颁奖过程中同时开展两种类型的研究活动。首先，将进行二次分析，从两个角度阐明家庭参与对晚年抑郁症诊断和治疗的影响：使用具有国家代表性的调查和相关的行政索赔以人群为导向(目标1)，以及通过检查现有的患者-(家庭)-医生办公室访问的录音接触从患者个人的角度(目标2)。第二组研究活动涉及主要数据收集。重点小组将与抑郁的老年人、他们的家人和初级保健保健专业人员一起进行，以确定家庭在抑郁症护理过程中采取的促进和相反的行为(目标3)。最后，在从目标1-3获得的知识的基础上，将开发一种旨在优化家庭参与抑郁症护理过程的干预措施，并进行试点测试(目标4)。拟议的培训计划和研究目标旨在为沃尔夫博士提供必要的额外经验和资源，以支持提交成功的R01赠款，以便在奖励期结束前严格测试这一干预措施的效果。

DESCRIPTION (provided by applicant): Jennifer L. Wolff, Ph.D. is an assistant professor at the Johns Hopkins Bloomberg School of Public Health who is trained in gerontology and health services and outcomes research. This proposed NIMH Mentored Research Scientist Career Development (K01) award will provide the necessary support to facilitate Dr. Wolff's successful transition to an independent investigator in the field of geriatric mental health services intervention research. Dr. Wolff's ultimate goal is to develop a program of research to optimize family involvement in late-life depression care processes, and in doing so, to facilitate improved mental health and quality of life outcomes among older adults living with depression. The proposed training plan includes a series of learning activities to increase the candidate's knowledge of late-life depression, its treatment, and models of depression care delivery, as well as to develop new skills in health education and communication research and the conduct of clinical trials. Building on these learning activities, two types of research activities will be simultaneously pursued throughout the course of the award. First, secondary analyses will be undertaken to elucidate the influence of family involvement on late-life depression diagnosis and treatment from two points of departure: a population-based orientation using a nationally representative survey and linked administrative claims (Aim 1), and an individual patient perspective through examination of existing audio-taped encounters of patient-(family)-physician office visits (Aim 2). The second set of research activities involves primary data collection. Focus groups will be conducted with depressed older adults, their families, and primary care health professionals to ascertain facilitative and counterproductive behaviors assumed by family in depression care processes (Aim 3). Lastly, building on knowledge gained from Aims 1- 3, an intervention that seeks to optimize family involvement in depression care processes will be developed and pilot tested (Aim 4). The proposed training plan and research aims are designed to provide Dr. Wolff with the additional experience and resources necessary to support the submission of a successful R01 grant to rigorously test the efficacy of this intervention by the end of the award period.