Optimizing Outcomes in Bipolar Illness Interventions in Hispanic Communities

位于圣安东尼奥的德克萨斯大学健康科学中心提议建立一个高级干预和/或服务研究中心，以开展研究，使双相情感障碍的社区治疗个性化，从而改善结局。我们将研究文化因素，坚持和参与，行为领域和生物因素与结果的相互作用，从而提供一个模型，可以改变目前的诊断和治疗模式的双相情感障碍。本申请的一个主要目的是更好地发展我们对西班牙裔美国人中双相情感障碍的理解，特别是文化适应对坚持治疗计划的影响。该计划将培训研究人员更有效地与这个最大的美国少数民族人口，特别是墨西哥裔美国人谁形成在美国的西班牙裔美国人的大多数，我们将传播我们开发的知识和方法，以更大的美国西班牙裔美国人社区，以及临床医生为双相情感障碍患者提供护理。该中心的研究将招募代表在社区环境中接受护理的所有患者的患者。这些项目将有助于开发更具成本效益的治疗方案，这些方案根据患者的特点进行个性化，并将耐受性与疗效同等重要。我们将开发和颁布研究设计，解决持续的利益和功能的结果，敏感的评估双相情感障碍的基本症状领域，和统计方法，强调病人的功能。这些努力将由我们在双相情感障碍研究方面的国家公认的领导者，经验丰富的科学工作人员，其中大多数也是西班牙裔，以及双相情感障碍不同方面研究的国家领导人推动。这些努力将使我们能够作为国家资源，通过研究治疗方法及其对患者的可接受性，推进NIMH减轻双相情感疾病负担的使命，并广泛传播这项研究，以改善临床护理，公共教育和公共卫生规划。

The University of Texas Health Science Center at San Antonio proposes to establish an Advanced Center for Interventions and/or Service Research to conduct research that will personalize community based treatment of bipolar disorders to improve outcomes. We will investigate interactions of cultural factors, adherence and engagement, behavioral domains and biological factors with outcomes, thereby providing a model that can transform current diagnostic and treatment paradigms for bipolar disorder. A major aim of this application is to better develop our understanding of bipolar disorder in the Hispanic American population, in particular the impact of acculturation on adherence to treatment programs. This program will train researchers to work more effectively with this largest U.S. minority population, particularity Mexican Americans who form the majority of Hispanics in the U.S. We will disseminate the knowledge and methodologies we develop to the larger U.S. Hispanic American community, as well as clinicians providing care for persons with bipolar disorder. The studies of the Center will enroll patients who are representative of the full spectrum of patients who receive care in community settings. These projects will contribute to development of more cost effective treatment regimens that are personalized to the characteristics of the patient and weigh tolerability as highly as efficacy. We will develop and promulgate study designs addressing sustained benefit and functional outcomes, sensitive assessments of the fundamental symptom domains in bipolar disorder, and statistical approaches that emphasize patient function. These efforts will be facilitated by our group of nationally recognized leaders in bipolar studies, an experienced scientific staff, the majority of whom are also Hispanic, and national leaders of research on diverse aspects of bipolar disorder. These efforts will equip us to serve as a national resource to advance the NIMH mission of reducing the burden of bipolar illness and improve outcomes through the efforts of research about treatments and their acceptability to patients, and broadly disseminate this research for the purposes of improving clinical care, public education and public health planning.