Community Partnered Approach to Implement EBPs for Depression

描述（由申请人提供）：与患有重度抑郁症的白色美国人相比，患有重度抑郁症（MDD）的非洲裔美国人有更大的疾病负担，接受更低质量的护理，并且未充分利用传统的心理健康服务。由于神职人员被认为是值得信赖的“看门人”，他们是心理健康教育和/或服务的社会经济多样化的非洲裔美国人的主要来源。然而，很少有研究调查如何将抑郁症的循证实践（EBP）转化为基于信仰的环境。这K23提出了一个并发的，混合方法的研究，调查利用社区合作参与式研究（CPPR）的方法，以支持神职人员在实施人际咨询（IPC）在信仰为基础的设置的可行性和可接受性。IPC是一种手动的3节抑郁干预，专为非心理健康专业人员（如神职人员）提供。我们的目标是帮助了解将EBP转化为真实的世界环境所涉及的因素，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。这项研究有三个主要阶段。第一阶段（愿景）旨在启动一个社区合作的方法，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理事会，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（山谷）是实施CPPR知情模式，以测试在两个非洲裔美国人教堂培训8名神职人员的可行性和可接受性。各教会将交错执行，以纳入社区的投入。患者结局将是抑郁症和功能水平。实施结果将是可行性、可接受性、采用、实施和维护。第三阶段（胜利）将允许社区成员提供关于研究设计的反馈并庆祝结果。 这些研究的执行将与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。由共同导师Myrna Weissman博士，Ken威尔斯博士和Loretta Jones女士领导，该应用程序包括以下职业培训目标：（1）学习和应用传播和实施科学的原则（丽莎狄克逊、雪莉·格利德、盖尔·怀亚特和海伦·韦德利博士）;（2）发展社区参与方面的专业知识（Alfiee Breland-Noble博士，Alwyn Cohall博士和Richard Ferreira先生）;（3）获得混合方法（定性/定量）研究设计的技能（Jennifer Wisdom，Mindy Fullilove和Priya Wickramaratne博士）。该研究计划为R 01提供数据，以进行一项群集随机对照试验，以测试在基于信仰的环境中实施IPC的不同方法。

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.