Exercise to prevent depression and anxiety in older Hispanics

描述(由申请人提供)：这项建议是关于K23指导下的以患者为导向的研究职业发展奖，该奖项将使候选人Daniel Jimenez成为一名独立资助的研究人员，拥有健康促进/健康行为改变干预方面的专业知识，旨在预防高危种族/少数民族老年人的常见精神疾病(抑郁和焦虑)。这位候选人和他在达特茅斯医学院、剑桥健康联盟和匹兹堡大学的导师设计了一份职业发展计划，其中包括学术教学和研讨会、专家指导、在达特茅斯学院、哈佛大学和匹兹堡大学的实践经验，以及可衡量的生产力，包括同行评议的手稿和拨款申请。他的三个职业发展目标是：1)在健康促进/健康行为改变干预措施的开发方面获得专业知识，以预防高危种族/少数族裔人口中常见的精神健康障碍；2)在抑郁和焦虑预防研究方面发展方法学专业知识，作为在种族/少数族裔老年人中进行健康促进/健康行为改变研究的基础；以及3)增加关于健康促进/健康行为改变干预措施对抑郁/焦虑风险因素的影响的知识。解决这些职业发展目标将为候选人提供技能和专业知识来实施本提案中的研究计划。将使用混合方法来开发和完善Happy老年拉丁裔活跃(HOLA)，这是一种由社区卫生工作者领导的体力活动干预措施，并在随机试验中证明该干预措施的可行性、可接受性和安全性。这项试点研究有三个具体目标：1)开发和改进HOLA，以解决患有轻度和阈值下抑郁和焦虑的一组年长拉丁裔人的抑郁和焦虑预防问题；2)评估新改进的HOLA与强化的心理教育条件相比在以下方面的可行性和潜在有效性：(A)预防抑郁和焦虑以及(B)3)评估HOLA在生理和心理社会功能方面与强化心理教育相比的可行性和潜在有效性。制定旨在预防常见精神障碍的健康促进干预措施，可作为解决种族/少数民族老年人之间的多重差异(例如，精神健康结果、精神卫生服务使用、耻辱)的手段。如果这些结果被证明是有希望的，将提交一份未来的R01提案，以进行一项充分有效的随机对照试验。此外，这项研究的结果可能会对其他高危、高度不利的人群产生影响，他们可以从拟议的健康促进干预中受益，以预防常见的和致残的精神障碍。

DESCRIPTION (provided by applicant): This proposal is for a K23 Mentored Patient Oriented Research Career Development Award that will prepare the candidate, Daniel Jimenez, become an independently funded researcher with expertise in health promotion/health behavior change interventions designed to prevent common mental illness (depression and anxiety) in at-risk racial/ethnic minority elderly. The candidate and his mentors at Dartmouth Medical School, Cambridge Health Alliance and the University of Pittsburgh have designed a career development plan, which is comprised of scholarly didactics and seminars, expert mentorship, hands-on experience at Dartmouth College, Harvard University, and the University of Pittsburgh as well as measurable productivity including peer- reviewed manuscripts and grant applications. His three career development aims are: 1) to gain expertise in the development of health promotion/health behavior change interventions to prevent common mental health disorders in high-risk older racial/ethnic minority populations; 2) to develop methodological expertise in depression and anxiety prevention research as a foundation for conducting health promotion/health behavior change research in racial/ethnic minority elderly; and 3) to gain increased knowledge on the effects of health promotion/health behavior change interventions on risk factors for depression/anxiety. Addressing these career development aims will provide the candidate with the skills and expertise to conduct the research plan in this proposal. A mixed methods approach will be used to develop and refine Happy Older Latinos are Active (HOLA), a physical activity intervention led by a community health worker, and to demonstrate feasibility, acceptability, and safety of the intervention in a randomized trial. This pilot study has three specific aims: 1) to develop and refine HOLA to address depression and anxiety prevention in a group of older Latinos with minor and subthreshold depression and anxiety; 2) to evaluate the feasibility and potential effectiveness of the newly refined HOLA compared to an enhanced psychoeducation condition with respect to: (a.) depression and anxiety prevention and (b.) depression and anxiety severity; 3) to evaluate the feasibility and potential effectiveness of HOLA compared to enhanced psychoeducation with respect to physical and psychosocial functioning. The development of a health promotion intervention designed to prevent common mental disorders could be a means of addressing multiple disparities (e.g. mental health outcomes, mental health service use, stigma) among racial/ethnic minority elderly. Should these results prove to be promising, a future R01 proposal for an adequately powered, randomized control trial will be submitted. Additionally, the results of this study could have implications fo other high risk, highly disadvantaged populations who could benefit from the proposed health promotion intervention in the service of preventing common and disabling mental disorders.