Center to Accelerate Translation of Interventions to Decrease Premature Mortality in SMI

加速转化干预措施以降低 SMI 过早死亡率的中心

• 批准号: 9762194
• 负责人: Gail L. Daumit
• 金额: $ 160.11万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9762194
• 关键词: Address; Adopted; Adoption; Advocacy; Behavior Therapy; Behavioral; Behavioral Research; Body Weight decreased; Cardiovascular Diseases; Caring; Cessation of life; Clinical; Clinical Research; Clinical Trials; Collaborations; Communication Methods; Communities; Comorbidity; Consultations; Criminal Justice; Development; Diabetes Mellitus; Diet; Discipline; Dyslipidemias; Engineering; Evidence based intervention; Evidence based practice; Faculty; Family member; Foundations; Funding; Future; Gap Junctions; Goals; Health; Health Communication; Health Personnel; Health Services Research; Health behavior change; Health system; Homelessness; Human; Hypertension; Individual; Intervention; Intervention Studies; Life Expectancy; Maryland; Medical; Mental Health; Mentorship; Methods; Obesity; Organizational Policy; Persons; Physical activity; Policy Maker; Population; Premature Mortality; Provider; Public Health; Quality of Care; Research; Research Methodology; Research Personnel; Resources; Risk Behaviors; Risk Factors; Science; Services; Smoking Cessation Intervention; Speed; System; Testing; Time; Tobacco smoking behavior; Training; Translating; Translations; Unhealthy Diet; Vision; Vulnerable Populations; cardiovascular disorder risk; cardiovascular risk factor; care delivery; cohort; design; effective intervention; evidence base; experience; health care service organization; health equity; implementation science; implementation strategy; improved; innovation; interest; medical specialties; mortality; mortality disparity; motivational enhancement therapy; peer; physical inactivity; premature; research study; research to practice; response; scale up; severe mental illness; smoking cessation; social; synergism; system-level barriers; years of life lost

Persons with serious mental illness (SMI) comprise one of the most highly vulnerable groups in the US, dying 10 to 20 years earlier and with mortality rates two to over three times higher than the overall population. Much of this premature death is attributable to cardiovascular disease (CVD) and is potentially preventable; all CVD risk behaviors (unhealthy diet, physical inactivity, tobacco smoking) and risk factors (obesity, hypertension, diabetes and dyslipidemia) are markedly elevated in persons with SMI. Concomitantly, persons with SMI often receive poor quality of care for these conditions. While these health and mortality gaps are widely recognized as a public health crisis, individual, provider, organizational, and policy level barriers impede progress. While many persons with SMI receive most of their care from the public mental health sector, tailored interventions to decrease CVD risk shown effective in clinical trials for those with SMI (e.g., for weight loss, smoking cessation) have not been widely adopted in community mental health settings. Meaningfully advancing health and decreasing mortality disparities for persons with SMI requires urgent development and testing of implementation strategies for scale-up of practical, effective interventions. In response to this extraordinary burden of years of life lost, our goal is to create the Center to Accelerate Translation of Interventions to Decrease Premature Mortality in SMI that will use cutting-edge transdisciplinary methods towards short and long-term progress to reduce CVD risk in this highly vulnerable population. The Center’s uniquely qualified team will conduct 3 R34 studies to develop and pilot test innovative implementation strategies to address all CVD risk behaviors and risk factors in persons with SMI in community mental health settings. The R34s will focus on evidence-based approaches for: 1) behavioral weight loss with diet and physical activity; 2) tobacco smoking cessation treatment; 3) care delivery for diabetes, hypertension and dyslipidemia. The Methods Core will use a transdisciplinary approach incorporating clinical and behavioral intervention research, implementation science, human factors engineering, systems science, and health services research to support Center research. The Methods Core will also advance research methods in 1) human factors engineering to support implementation; 2) avatar-assisted training and assessment in motivational interviewing; 3) quantitative methods to support intervention scale-up; 4) and systems science. The Administrative Core will engage stakeholders, building on well-established partnerships in Maryland and nationally, and bring together all of the Center’s activities. The gaping differential in life expectancy and CVD risk factor burden in persons with SMI calls for concentrated, transdisciplinary approaches to solutions. This Center will create a nexus of innovation and momentum around T2 translation to reduce premature mortality in SMI. Our vision is health equity – that persons with SMI, similar to persons without SMI, live long healthy lives.

严重精神疾病患者（SMI）是美国最脆弱的群体之一，