Developing and Translating Interventions to Decrease Mortality Disparities in SMI

描述（由申请人提供）：患有严重精神疾病（SMI）的人有很大的医疗合并症负担，死亡率比总人口高2至3倍以上，对心理健康消费者及其家庭构成公共卫生危机。NIMH的战略计划、医学研究所和SAMSHA都强调降低重度精神障碍患者的死亡率是优先事项。与此同时，在研究环境中的有效卫生干预措施与转化为社区之间存在很大差距。要实现减少重度精神分裂症患者总体健康和死亡率差异的目标，就需要具有各种专门知识的调查人员，特别是在实施研究方面，有效地将干预措施转化为改善健康。这是NIMH K24面向患者研究的中期职业研究者奖的修订申请，旨在为致力于临床研究的初级保健医生提供支持，以降低重度精神分裂症患者的医疗发病率和死亡率，并改善其整体健康状况。Daumit博士是一名执业内科医生、流行病学家和卫生服务研究员，长期致力于以患者为导向的调查，这反映在她的研究项目和对初级调查员的指导上。在她目前的工作中，她成功地建立了多学科团队，为重度精神障碍患者开发和评估适当适应的行为生活方式干预措施。因此，她以独特的姿态成长为一名领导者，努力改进已证实的干预措施的实施和可持续性，促进重度精神障碍患者的健康和生活质量。她的近期职业目标是：1)掌握实施研究理论和方法的技能，包括混合方法设计，以评估降低重度精神障碍患者健康风险的干预措施的可持续性；2)扩大她在理解重度精神障碍患者死亡率增加的原因以及制定和实施可持续的个人层面和系统层面的改善身体健康战略方面的工作；3)继续为初级临床研究人员提供优秀的指导，并吸引新的研究人员指导进行严格的以患者为导向的研究，以解决重度精神障碍患者的健康问题。通过K24，她将获得实施研究方法方面的新知识，并将这些技术应用于将可持续解决方案转化为实践和政策，改善这一弱势群体的身体健康，并扩大其工作对公共卫生的影响。拟议的研究将采用混合方法来研究与nimh资助的干预措施的可持续性相关的因素，这些干预措施促进了马里兰州和新罕布什尔州心理健康环境中的身体健康。通过提供薪酬支持、培训、免除行政责任和提供指导的正式结构，该奖项将促进她从中级研究员过渡到高级研究员，致力于开发和翻译干预措施，以减少重度精神障碍患者的健康差异。

DESCRIPTION (provided by applicant): Persons with serious mental illness (SMI) have a large burden of medical comorbid conditions and mortality rates two to over three times higher compared to the overall population, constituting a public health crisis for mental health consumers and their families. NIMH's Strategic Plan, the Institute of Medicine and SAMSHA all emphasize decreasing mortality for persons with SMI as priorities. At the same time, a wide gap exists between effective health interventions in research settings and translation into the community. Achieving the goals of reducing disparities in overall health and mortality for those with SMI requires investigators with varied expertise, particularly in implementation research, to effectively translate interventions to improve health. This revised application for an NIMH K24 Mid-Career Investigator Award in Patient-Oriented Research seeks support for a primary care physician dedicated to a career in clinical research to decrease medical morbidity and mortality and improve overall health in persons with SMI. Dr. Daumit is a practicing general internist, epidemiologist and health services researcher with a longstanding commitment to patient oriented investigation, reflected in her research program and mentoring of junior investigators. Bridging mental health and medical fields, she successfully builds multidisciplinary teams in her current work to develop and evaluate appropriately adapted behavioral lifestyle interventions for persons with SMI. She is thus uniquely poised to grow as a leader in the effort to improve implementation and sustainability of proven interventions that promote health and quality of life for persons with SMI. Her immediate career objectives are: 1) To acquire skills in implementation research theory and methods including mixed methods designs to evaluate sustainability of interventions to decrease health risks in persons with SMI; 2) To amplify her work in understanding causes for increased mortality in persons with SMI and in developing and implementing sustainable person-level and systems-level strategies for improving physical health; and 3) To continue to provide outstanding mentorship for junior clinician investigators and attract new investigators to mentor in the conduct of rigorous patient- oriented research to address health issues in persons with SMI. Through the K24, she will gain new knowledge in implementation research methods and apply these techniques to translate sustainable solutions into practice and policy, improve physical health in this vulnerable population, and amplify the public health impact of her work. The proposed research will employ mixed methods to study factors related to sustainability of NIMH-funded interventions that promote physical health in mental health settings in Maryland and New Hampshire. By providing salary support, training, freedom from administrative responsibilities, and formal structure for providing mentorship, this award will facilitate her transition from a mid-level to a senior investigator committed to a career in developing and translating interventions to reduce disparities in health for persons with SMI.