Optimizing Family Involvement in Late-Life Depression Care

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Jennifer L. Wolff, Ph.D. is an assistant professor at the Johns Hopkins Bloomberg School of PublicHealth who is trained in gerontology and health services and outcomes research. This proposed NIMHMentored Research Scientist Career Development (KOI)award will provide the necessary support to facilitate Dr. Wolffs successful transition to an independent investigator in the field of geriatric mentalhealth services intervention research. Dr. Wolffs 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 clinicaltrials. Buildingon 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 elucidatethe influence of family involvementon late-life depression diagnosisandtreatment from two points of departure: a population-based orientation using a nationallyrepresentative survey and linked administrative claims (Aim 1), and an individual patient perspective through examinationof 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 facilitativeand counterproductive behaviors assumed by family in depression care processes (Aim 3). Lastly, building on knowledge gained from Aims 1- 3, an interventionthat 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 additionalexperience and resources necessary to support the submissionof a successful R01 grant to rigorously test the efficacy of this intervention by the end of the award period.