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Place-based Strengths and Vulnerabilities for Mental Wellness among Rural Minority Seniors

农村少数民族老年人心理健康的地方优势和劣势

基本信息

批准号：
10712843
负责人：
Elise Trott Jaramillo
金额：
$ 20.71万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10712843
关键词：
Address Advocate Affect Age Aging American Indians Characteristics Chronic Colonialism Communities Community Health Community Psychology Community Services Complement Complex Data Data Analyses Development Diagnosis Disadvantaged Disparity Economics Educational workshop Elderly Environmental Risk Factor Ethnic Origin Evaluation Evaluation Studies Family member Federally Qualified Health Center Food Friends Fright Funding Future Gender Geography Goals Government Health Health Planning Health Services Health system Healthcare Impaired cognition Individual Inequity Insurance Coverage Interdisciplinary Study Intervention Interview Knowledge Latinx Link Mental Depression Mental Health Mental Health Services Mental disorders Mentally Ill Persons Mentors Methodology Methods Minority Minority Groups National Institute on Minority Health and Health Disparities New Mexico Pathway Analysis Physical environment Policy Making Population Process Protocols documentation Provider Public Health Qualitative Research Race Recording of previous events Research Research Institute Research Personnel Role Rural Rural Community Rural Health Services Rural Minority Rural Population Scholarship Science Services Shapes Social Environment Social Work Social support Structure Surveys System Targeted Research Texas Training Translating Transportation Trauma Tribes Underserved Population United States United States Indian Health Service United States National Institutes of Health Universities Well in self access disparities aging population care systems comorbidity depressive symptoms design ethnic minority ethnic minority population experience farmer health care disparity health care service health care service organization health care settings health disparity health equity health inequalities help-seeking behavior implementation science implementation study improved intervention mapping marginalized population mortality protective factors racial minority resilience rural Americans rural area rural residence rurality safety net skills social social culture social factors social health determinants social stigma social structure stem structural determinants theories therapy development

项目摘要

Project Summary Severe inequities in depression and its diagnosis and treatment among rural-dwelling, racial/ethnic minority seniors compared to their urban White counterparts result in increased mortality, cognitive impairment, and multiple co-morbidities, thus presenting a growing public health concern as the United States population ages. These health inequities are often attributable to social and environmental factors, including economic insecurity, histories of trauma, chronic gaps in transportation and safety-net services (e.g., food assistance, health care), and disparities in access to policymaking processes rooted in colonialism that make these groups “structurally vulnerable” to mental ill health. Fewer data exist on protective factors associated with social and environmental contexts, such as proximity of social support, community attachment, and a meaningful sense of place. While the importance of such place-based factors is widely recognized in scholarship on the social determinants of health, there is to date little research specifically examining how such factors shape disparities in depression and treatment, as well as limited practical approaches to target these factors and their effects on mental wellbeing for rural and minority populations. This K99/R00 application proposes to integrate my expertise as a cultural anthropologist in participatory qualitative research and implementation science with new knowledge in rural mental health research, quantitative and mixed-method designs, and intervention development, in order to conceptualize and intervene on the social and environmental causes of mental health disparities. Coursework, workshops, and the expertise of an interdisciplinary team of mentors at the Pacific Institute for Research and Evaluation and the University of New Mexico during the K99 period will provide me with the skills to undertake the proposed R00 research, which will utilize quantitative surveys, qualitative interviews, ecological network research, and spatial data analysis to elucidate how place-based vulnerabilities and protective factors shape experiences of depression among rural American Indian and Latinx elders in New Mexico. Guided by Intervention Mapping, a participatory approach for planning health interventions, data will contribute to a community-driven plan for a multisystem intervention targeting the place-based causes of disparities in depression, which will form the basis of a subsequent R01 implementation and evaluation study. This participatory and interdisciplinary study will elucidate how axes of difference pertaining to place, rurality, and minority status drive mental health disparities. The resulting place-focused intervention plan will improve mental health equity for aging populations that data show are severely and persistently underserved and advance the science of intervention and implementation beyond its predominant focus on individuals and healthcare settings. Data and training will contribute to my independence as an investigator focused on the social causes of health disparities and translate directly into future NIH-funded research targeting the upstream causes of mental health disparities in this and other underserved populations.

项目总结