Developing and Translating Interventions to Decrease Mortality Disparities in SMI

描述(由申请人提供)：严重精神疾病(SMI)患者的疾病负担很大，与总人口相比，死亡率高出两到三倍以上，对精神健康消费者及其家人构成公共健康危机。NIMH的战略计划、医学研究所和SAMSHA都强调将降低SMI患者的死亡率作为优先事项。与此同时，在研究环境中进行有效的卫生干预与将其转化为社区之间存在着巨大的差距。要实现减少SMI患者总体健康和死亡率差异的目标，需要具有不同专业知识的调查人员，特别是在实施研究方面，以有效地将干预措施转化为改善健康。本次修订后的NIMH K24以患者为中心的研究生涯中期研究员奖申请旨在支持一位致力于临床研究事业的初级保健医生，以降低SMI患者的发病率和死亡率，并改善其整体健康状况。道米特博士是一名执业的普通内科医生、流行病学家和卫生服务研究员，长期致力于以患者为中心的调查，这反映在她的研究计划和对初级调查人员的指导中。作为心理健康和医学领域的桥梁，她在目前的工作中成功地建立了多学科团队，为SMI患者开发和评估适当适应的行为生活方式干预措施。因此，她在努力改善行之有效的干预措施的实施和可持续性方面具有独特的优势，她将成为一名领导者，以促进SMI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方面的技能，包括混合方法设计，以评估降低SMI患者健康风险的干预措施的可持续性；2)扩大她在了解SMI患者死亡率上升原因以及制定和实施可持续的个人和系统层面改善身体健康策略方面的工作；以及3)继续为初级临床医生研究员提供出色的指导，并吸引新的研究人员指导SMI患者进行严格的以患者为导向的研究，以解决SMI患者的健康问题。通过K24，她将在实施研究方法方面获得新的知识，并应用这些技术将可持续的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，并扩大她的工作对公共卫生的影响。这项拟议的研究将使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，这些干预措施在马里兰州和新罕布夏州的精神健康环境中促进身体健康。通过提供工资支持、培训、免除行政责任以及提供指导的正式结构，该奖项将促进她从中级人员过渡到高级调查员，致力于开发和转换干预措施，以减少SMI患者的健康差距。

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.