Optimizing Family Involvement in Late-Life Depression Care

简介（由申请人提供）：Jennifer L. Wolff博士，约翰霍普金斯大学彭博公共卫生学院助理教授，接受过老年学、卫生服务和结果研究方面的培训。这个拟议的NIMH指导研究科学家职业发展（K01）奖将提供必要的支持，以促进Wolff博士成功过渡到老年心理健康服务干预研究领域的独立研究者。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，并在此过程中促进改善老年抑郁症患者的心理健康和生活质量。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、抑郁症治疗和抑郁症护理模式的认识，以及发展健康教育和交流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，两种类型的研究活动将在整个课程中同时进行。首先，将进行二次分析，从两个出发点阐明家庭参与对晚年抑郁症诊断和治疗的影响：基于人口的方向，使用具有全国代表性的调查和相关的行政索赔（目标1），以及通过检查患者（家庭）医生办公室就诊的现有录音，从个体患者的角度来看（目标2）。第二组研究活动涉及原始数据收集。焦点小组将与抑郁的老年人、他们的家人和初级保健卫生专业人员一起进行，以确定家庭在抑郁护理过程中所采取的促进和反生产行为（目标3）。最后，基于从目标1- 3中获得的知识，将开发和试点测试一种旨在优化抑郁症护理过程中的家庭参与的干预措施（目标4）。拟议的培训计划和研究目标旨在为Wolff博士提供额外的经验和必要的资源，以支持在奖励期结束时成功提交R01资助，严格测试该干预措施的有效性。

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.