Optimizing Family Involvement in Late-Life Depression Care

描述（由申请人提供）：Jennifer L.沃尔夫博士是约翰霍普金斯布隆伯格公共卫生学院的助理教授，他接受过老年学、卫生服务和成果研究方面的培训。这项拟议的NIMH指导研究科学家职业发展（K 01）奖将提供必要的支持，以促进沃尔夫博士成功过渡到老年心理健康服务干预研究领域的独立调查员。沃尔夫的最终目标是开发一个研究计划，以优化家庭参与晚年抑郁症护理过程，并在这样做的过程中，促进改善老年人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，其治疗和抑郁症护理模式的了解，以及发展健康教育和沟通研究以及临床试验的新技能。在这些学习活动的基础上，两种类型的研究活动将在整个颁奖过程中同时进行。首先，二次分析将进行阐明家庭参与晚年抑郁症的诊断和治疗的影响，从两个出发点：一个人口为基础的方向，使用全国代表性的调查和相关的行政索赔（目标1），和个别患者的角度，通过检查现有的录音遇到的病人（家庭），医生的办公室访问（目标2）。第二组研究活动涉及原始数据收集。焦点小组将与抑郁症老年人，他们的家人和初级保健卫生专业人员进行，以确定家庭在抑郁症护理过程中采取的促进和适得其反的行为（目标3）。最后，在从目标1- 3中获得的知识的基础上，将制定一项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Wolff博士提供必要的额外经验和资源，以支持提交成功的R 01补助金，以便在奖励期结束时严格测试这种干预措施的有效性。

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.