Partnered Research Center for Quality Care

优质护理合作研究中心

• 批准号: 7682251
• 负责人: KENNETH B. WELLS
• 金额: $ 159.51万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-05 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7682251
• 关键词: Partnered; Research; Center; Quality; Care

DESCRIPTION OVERALL (provided by applicant): This application for an Advanced Center for Services and Intervention Research, "NIMH Partnered Research Center for Quality Care," is a collaboration of UCLA, RAND, and USC, and health plan, services agency, and community and consumer partners in Los Angeles and other. The Center focuses on two themes: 1) improving access to quality mental health services in communities through studying the impact of interventions at policy, practice, and community levels; and 2) partnerships in research and program development, implementation, and evaluation to achieve science that is formed by and can inform community-based services delivery. We propose a partnered center structure, with academic and community co-leaders for all cores, units, and pilots. We focus on signature conditions (e.g., depression/anxiety, schizophrenia, and youth exposure to violence), and respond to partner priorities. We will apply principles of community partnered participatory research, including equal power in all research stages, trust development, and assuring mutual benefit and capacity building. The Operations Core will promote joint leadership of the Center, provide administrative and technical support, support theory and intervention development and application, develop new academic and community leaders, and facilitate research development with public partners. The Methods Core will provide design and biostatistical methodological support for partnered research, including qualitative, mixed methods, and rapid evaluation response, measures development and application, and use of policy analysis; and sponsor a partnered Methods R34 on organizational networks and a New Investigator pilot on cost-effectiveness measures. The Principal Research Core will support 3 partnered R34s and host a unit to enhance the translation of research into state use. The R34s develop a consumer-provider intervention to support recovery in severe mental illness, analyze data from a natural experiment to understand consumer decisions to enroll in consumer-based health plans, and examine factors affecting dissemination of an evidence-based school intervention for child trauma. The Network Core will support the application of CPPR principles, develop partnership strategies, support consumer research leadership, and evaluate Center impact on community and academic members. This core includes a Partnered New Investigator Pilot in New Orleans and hosts an annual Community Quality Forum to identify priorities for and initiate new partnered studies. RESUME OF INDIVIDUAL PROJECTS AND CORES CORE 1: Operations Core (PI: Kenneth Wells): The Operations Core of this ACISIR application supports center leadership and consists of five units: Administration; Data Management, Analysis, and Technology; Theory and Intervention Development and Application; Investigator Development; and Public Liaison. Although not particularly innovative in structure, these units are appropriate and well positioned to complete their roles within the center. The Investigator Development Unit, with a focus on training of new investigators, is a particular strength. The Center describes what is called a Community Partnered Participation Research (CPPR) approach to involving community members in the planning and running of the center, including in leadership positions. Although similar to the participatory action research (PAR) approach used in other research enterprises, this model is relatively new for mental health and particularly for this type of center mechanism. The involvement of community stakeholders in leadership of the center is laudable, the focus of the partnership to Health African American Families (HAAF), an organization partially created by UCLA, reduces potential generalizability of the effort to other types of community organizations. A potential weakness of the Operations Core is that it is apparently set off as one arm of the center, rather than as a central entity guiding the work of other cores. Overall, this Core was considered to be very strong, but with some weaknesses as noted (Score: 164). CORE 2: Research Methods Core (PI: Thomas Belin): The Research Methods Core (RMC) proposes four units: biostatics, qualitative/mixed-methods, measurement, and policy. Each unit is led by investigators at the top of their field and there is evidence of integration of the work of this Core with the Operations Core. The RMC has particular strengths in the public health significance of the model and the innovativeness of the Core and the R34 Methods Pilot that is likely to improve dissemination to diverse stakeholders and agencies. The Policy Unit appears to be particularly integrative for the center as a whole, indicating the key role of public policy issues within the framework of the center. Some questions persist regarding the commitment to ethnic and cultural issues within this Core (much of that discussion appears to be elsewhere in the application but not as clear here). Although it appears that the methodologists leading this Core are clearly engrained into the functioning of the center as a whole, it also appears that the Core PI is not part of the Operations Core, leading to questions about the overall organization of the center. Overall, however, the weaknesses were considered very minor given the significant strengths of this Core (Score: 134). CORE 3: Principal Research Core (PI: Jeanne Miranda): The Principal Research Core (PRC) has as its goals to promote development of new investigators, and to conduct research through three R34-like studies. The importance of the first R34 study of the Role of Psychiatric History in Selection of and Experience with Consumer-Driven Health Plans is an important topic of study, but the application does not make a convincing case for the significance of the particular pilot study being proposed. The other two pilots provide well justified arguments for the importance of the proposed efforts. The link between the pilot projects and the conceptual model of the center was not entirely clear to all reviewers, and there was a sense that the projects were not clearly integrated into the center. The goal of new investigator development might also be described more clearly. The affiliated studies piece is insufficiently described, but appears to involve the types of pilot projects described in the program announcements. These might have been more clearly delineated. Despite these weaknesses, the PRC has a number of strengths, particularly related to the investigators and environment presented. The need to advance knowledge about implementation of evidence based strategies in various areas of activity and various communities while simultaneously developing capacity is strongly argued and supported. Overall, the Principal Research Core was considered to be very strong, but with some weaknesses as noted (Score: 168). CORE 4: Network Core (PI: Paul Koegel): The specific aim of the Network Core is both to support real partnerships between the Research Center and community based partners and advance the knowledge of how partnerships can be most effectively utilized. The purpose in doing this is the belief that a "quality chasm" exists between knowledge of the best practices and the translation of this knowledge into services. A major strength of the Network Core is this goal to cross the quality chasm and the clear attempts made to do so. There is a well-thought out plan to involve community stakeholders and to build on to the existing network by expanding connections. The Network Core's goals are truly central to the goals of the center as a whole in terms of creating a participatory structure for research planning and engagement. Although the rationale for undertaking some of the activities described is not as clear as in other parts of the center, overall this Core was considered to be very strong with few weaknesses (Score: 134). OPERATIONS CORE DESCRIPTION (provided by applicant): This is an application for the Operations Core of the NIMH "Partnered Research Center for Quality Care," a proposed Advanced Services and Interventions Research Center. We propose a Center that is partnered throughout components with community and academic co-leads. The Operations Core will facilitate collaboration in leadership, foster new collaborations within Los Angeles and with other sites, support the administrative and technical operations of partnered pilots and major affiliated studies, and help assure benefits from research products for community and academic stakeholders. The core's leadership includes the PI's of the lead academic institutions (Wells, Sherbourne, Lagomasino) and a lead community partner (Daly). The Core supports Center leadership, which includes a 7-member Steering Committee of senior investigators and community leaders, and an Executive Council that includes the academic and community leaders of all cores, units, and pilots. We will institute a leadership approach to support consensus decisions while assuring accountability, rigor, and productivity. The Core will have 5 units. The Administration Unit will provide Core leadership, support community liaison functions, provide high quality administrative support for partnered research, disseminate Center findings and products, and build collaborations with other groups and sites for partnered research. The Data Management, Analysis, and Technology Unit will provide high quality data management and analysis services, develop and maintain data sets, and support high-quality information technology. The Theory and Intervention Development and Application Unit will facilitate selection and use of theories, including a Center framework for diffusion of interventions to diverse stakeholders in a community context; facilitate adaptation of Center intervention resources; help match theory and interventions for diverse populations, and conduct partnered research on the feasibility of developing an intervention to extend the benefits of quality improvement interventions for depression by activating social networks. The Investigator Development Unit will use mentoring, seminars, and protection of time and resources to develop new academic and community leaders for partnered research. A Public Liaison unit will help initiate new partnered research studies fitting the priorities of the Los Angeles County Department, of Mental Health Services and the Los Angeles County Department of Health Services + University of Southern California Healthcare Network.

总体描述（由申请人提供）：这份高级服务和干预研究中心的申请，即“NIMH 优质护理合作研究中心”，是加州大学洛杉矶分校、兰德公司和南加州大学以及洛杉矶等地的健康计划、服务机构以及社区和消费者合作伙伴的合作项目。该中心重点关注两个主题：1）通过研究政策、实践和社区层面干预措施的影响，改善社区获得优质精神卫生服务的机会； 2) 研究和计划开发、实施和评估方面的伙伴关系，以实现由社区服务提供形成并可为社区服务提供提供信息的科学。我们提出了一个合作中心结构，所有核心、单位和试点都有学术和社区联合领导。我们关注标志性病症（例如抑郁/焦虑、精神分裂症和青少年遭受暴力的情况），并响应合作伙伴的优先事项。我们将应用社区合作参与性研究的原则，包括所有研究阶段的平等权力、信任发展以及确保互利和能力建设。运营核心将促进中心的联合领导，提供行政和技术支持，支持理论和干预措施的开发和应用，培养新的学术和社区领导者，并促进与公共合作伙伴的研究发展。方法核心将为合作研究提供设计和生物统计方法支持，包括定性、混合方法和快速评估响应、措施开发和应用以及政策分析的使用；并赞助关于组织网络的合作方法 R34 和关于成本效益措施的新研究者试点。主要研究核心将支持 3 个合作的 R34，并设立一个单位来加强研究成果向国家用途的转化。 R34 制定消费者-提供者干预措施以支持严重精神疾病的康复，分析自然实验的数据以了解消费者参加基于消费者的健康计划的决定，并研究影响基于证据的学校儿童创伤干预措施传播的因素。网络核心将支持 CPPR 原则的应用，制定合作伙伴战略，支持消费者研究领导力，并评估中心对社区和学术成员的影响。该核心包括新奥尔良的合作新研究者试点，并举办年度社区质量论坛，以确定优先事项并启动新的合作研究。 个别项目和核心的简历 核心 1：运营核心（PI：Kenneth Wells）：该 ACISIR 应用程序的运营核心支持中心领导，由五个单元组成：管理；数据管理、分析和技术；理论和干预措施的开发和应用；研究者发展；和公共联络。 尽管这些单位在结构上并不是特别创新，但它们的位置适当且位置优越，可以在中心内完成其职责。 调查员发展部门的重点是培训新调查员，是一个特殊的优势。该中心描述了所谓的社区合作参与研究（CPPR）方法，让社区成员参与中心的规划和运营，包括担任领导职务。 尽管与其他研究企业使用的参与性行动研究（PAR）方法类似，但这种模型对于心理健康，特别是对于此类中心机制来说相对较新。 社区利益相关者参与该中心的领导是值得称赞的，与健康非洲裔美国家庭（HAAF）（一个由加州大学洛杉矶分校部分创建的组织）合作的重点，降低了这项工作对其他类型社区组织的潜在普遍性。 运营核心的一个潜在弱点是，它显然是作为中心的一个分支，而不是作为指导其他核心工作的中央实体。 总体而言，该核心被认为非常强大，但也存在一些弱点（分数：164）。 核心 2：核心研究方法（PI：Thomas Belin）：核心研究方法 (RMC) 提出了四个单元：生物统计学、定性/混合方法、测量和政策。每个单位都由各自领域的顶尖调查员领导，并且有证据表明该核心的工作与运营核心相结合。 RMC 在模型的公共卫生意义以及核心和 R34 方法试点的创新性方面具有独特的优势，这可能会改善向不同利益相关者和机构的传播。 政策股对于整个中心来说似乎特别具有综合性，这表明公共政策问题在中心框架内发挥着关键作用。 关于该核心内对种族和文化问题的承诺，仍然存在一些问题（大部分讨论似乎在申请的其他地方，但在这里不太清楚）。 尽管领导该核心的方法学家似乎已明确融入该中心的整体运作中，但核心 PI 似乎并不是运营核心的一部分，这导致了对该中心整体组织的质疑。 然而，总的来说，考虑到该核心的显着优势（得分：134），这些弱点被认为是非常小的。 核心3：主要研究核心（PI：Jeanne Miranda）：主要研究核心（PRC）的目标是促进新研究者的发展，并通过三项类似R34的研究进行研究。 第一个关于精神病史在消费者驱动的健康计划的选择和体验中的作用的 R34 研究的重要性是一个重要的研究主题，但该申请并没有为所提议的特定试点研究的重要性提供令人信服的案例。另外两个试点项目为拟议工作的重要性提供了充分合理的论据。 所有评审者并不完全清楚试点项目与中心概念模型之间的联系，并且有一种感觉，这些项目没有明确融入该中心。 新研究者发展的目标也可能被更清楚地描述。 附属研究文章描述不充分，但似乎涉及计划公告中描述的试点项目类型。这些可能已经被更清楚地描述了。 尽管存在这些弱点，中华人民共和国仍具有许多优势，特别是与调查人员和环境相关的优势。人们强烈主张和支持需要增进关于在各个活动领域和各个社区实施基于证据的战略的知识，同时发展能力。总体而言，主要研究核心被认为非常强大，但也存在一些弱点（分数：168）。 核心 4：网络核心（PI：Paul Koegel）：网络核心的具体目标是支持研究中心和社区合作伙伴之间的真正伙伴关系，并增进有关如何最有效地利用伙伴关系的知识。这样做的目的是相信最佳实践知识与将知识转化为服务之间存在“质量鸿沟”。网络核心的主要优势在于跨越质量鸿沟的目标以及为此做出的明确尝试。 有一个深思熟虑的计划，让社区利益相关者参与进来，并通过扩大联系来建立现有网络。 在创建研究规划和参与的参与结构方面，网络核心的目标对于整个中心的目标来说确实是核心。 尽管开展所述某些活动的理由并不像中心其他部分那样明确，但总体而言，该核心被认为非常强大，几乎没有弱点（得分：134）。 运营核心 描述（由申请人提供）：这是 NIMH“优质护理合作研究中心”运营核心的申请，该中心是一个拟议的高级服务和干预研究中心。我们提议建立一个与社区和学术共同领导的各个组成部分合作的中心。运营核心将促进领导层的合作，促进洛杉矶内部以及与其他地点的新合作，支持合作试点和主要附属研究的行政和技术运营，并帮助确保社区和学术利益相关者从研究产品中受益。核心领导层包括主要学术机构（Wells、Sherbourne、Lagomasino）的 PI​​ 和主要社区合作伙伴（Daly）。核心支持中心的领导，其中包括由高级研究人员和社区领导者组成的 7 名指导委员会，以及包括所有核心、单位和试点的学术和社区领导者的执行委员会。我们将制定领导方法来支持共识决策，同时确保问责制、严谨性和生产力。核心将有 5 个单元。行政部门将提供核心领导，支持社区联络职能，为合作研究提供高质量的行政支持，传播中心的研究结果和产品，并与其他团体和地点建立合作研究的合作关系。数据管理、分析和技术部门将提供高质量的数据管理和分析服务，开发和维护数据集，并支持高质量的信息技术。理论和干预措施开发和应用部门将促进理论的选择和使用，包括向社区背景下的不同利益相关者传播干预措施的中心框架；促进中心干预资源的调整；帮助针对不同人群匹配理论和干预措施，并就开发干预措施的可行性进行合作研究，以通过激活社交网络来扩大抑郁症质量改善干预措施的益处。研究者发展部门将利用指导、研讨会以及时间和资源保护来为合作研究培养新的学术和社区领导者。公共联络单位将帮助启动新的合作研究，以适应洛杉矶县心理健康服务部和洛杉矶县卫生服务部+南加州大学医疗保健网络的优先事项。