Community Partnered Approach to Implement EBPs for Depression

描述(申请人提供)：与患有严重抑郁障碍(MDD)的美国白人相比，患有严重抑郁障碍(MDD)的非裔美国人的疾病负担更重，接受的护理质量更低，传统的精神卫生服务也得不到充分利用。因为神职人员被认为是值得信赖的“看门人”，他们是不同社会经济背景的非裔美国人心理健康教育和/或服务的主要来源。然而，很少有研究研究如何将抑郁症的循证实践(EBP)转化为基于信仰的环境。这项K23建议同时进行混合方法研究，以调查利用社区合作的参与性研究(CPPR)方法来支持神职人员在基于信仰的环境中实施人际咨询(IPC)的可行性和可接受性。IPC是一种由非心理健康专业人员(如神职人员)提供的三节课的手动抑郁症干预。我们的目标是促进对将EBPS转化为现实世界环境所涉及的因素的理解，这些知识可用于向服务不足的人群传播干预措施，并减少健康差距。这项研究分为三个主要阶段。第一阶段(愿景)旨在启动一种社区合作的方法，以计划如何在基于信仰的环境中实施IPC。它将产生一个社区指导委员会，该委员会将指导所有研究活动并为神职人员制定具体的执行战略。第二阶段(谷地)是实施CPPR知情模式，以测试在两个非裔美国人教会的IPC培训8名神职人员的可行性和可接受性。实施将在各教堂交错实施，以纳入社区意见。患者的结果将是抑郁症状和功能水平。实施结果将是可行性、可接受性、采纳性、实施和维护性。第三阶段(胜利)将允许社区成员就研究设计提供反馈并庆祝结果。这些研究的实施将与一项综合培训计划相结合，该计划将教学讲座与指导经验相结合。该应用程序由共同导师Myrna Weissman博士、Ken Wells博士和Loretta Jones女士领导，包括以下职业培训目标：(1)学习并应用传播和实施科学的原则(Lisa Dixon、Sherry Gly、Gail Wyatt和Helen Verdeli博士)；(2)发展社区参与方面的专业知识(Alfiee Bland-Noble博士、Alwyn CoHall博士和Richard Ferreira先生)；以及(3)获得混合方法(定性/定量)研究设计的技能(Jennifer Wisdom、Mindy Fullilove和Priya Wickraatne博士)。该研究计划为R01提供数据，以进行一项整群随机对照试验，以测试在基于信仰的环境中实施IPC的不同方式。

DESCRIPTION (provided by applicant): African Americans with major depressive disorder (MDD) have greater disease burden, receive lower quality care, and under-utilize traditional mental health services compared to white Americans with MDD. Because clergy are regarded as trusted "gatekeepers," they are the primary source of mental health education and/or services for socioeconomically diverse African Americans. However, few studies investigate how to translate evidence-based practices (EBPs) for depression into faith-based settings. This K23 proposes a concurrent, mixed-methods study to investigate the feasibility and acceptability of utilizing a community-partnered participatory research (CPPR) approach to support clergy in implementing Interpersonal Counseling (IPC) in faith-based settings. IPC is a manualized, 3-session depression intervention that was designed for delivery by non-mental health professionals, such as clergy. We aim to contribute an understanding of the factors involved in translating EBPs into real world settings, knowledge that could be used to disseminate interventions to underserved populations and reduce health disparities. This study has three main phases. The first phase (Vision) is designed to initiate a community-partnered approach to plan how to implement IPC in faith-based settings. It will yield a Community Steering Council that will guide all research activities and develop a specific implementation strategy for clergy. The second phase (Valley) is the implementation of a CPPR informed model to test the feasibility and acceptability of training 8 clergy in IPC at two African American churches. Implementation will be staggered across churches to incorporate community input. Patient outcomes will be depressive symptomatology and level of functioning. Implementation outcomes will be feasibility, acceptability, adoption, implementation, and maintenance. The third phase (Victory) will allow community members to provide feedback on the study design and celebrate results. Execution of these studies will be combined with a comprehensive training program that integrates didactic lectures with mentored experiences. Led by co-mentors, Dr. Myrna Weissman, Dr. Ken Wells, and Ms. Loretta Jones, the application encompasses the following career training goals: (1) to learn and apply principles of dissemination and implementation science (Drs. Lisa Dixon, Sherry Glied, Gail Wyatt, and Helen Verdeli); (2) to develop expertise in community engagement (Dr. Alfiee Breland-Noble, Dr. Alwyn Cohall, and Mr. Richard Ferreira); and (3) to gain skills in mixed-methods (qualitative/quantitative) study designs (Drs. Jennifer Wisdom, Mindy Fullilove, and Priya Wickramaratne). The research plan produces data for a R01 to conduct a cluster-randomized controlled trial to test different ways to implement IPC in faith-based settings.