A community intervention to promote evidence-based mental health care for olderadults with depressive and anxiety symptoms.

项目摘要/摘要 这是对奥斯卡·弗洛雷斯-弗洛雷斯医学硕士的K43 Fogarty新兴全球领导者奖的申请。 作为一名年轻的研究人员，弗洛雷斯-弗洛雷斯博士表现出了巨大的潜力，并拥有在 低收入和中等收入国家老龄化和慢性病的流行病学。然而，他是 现在提议获得实施科学方面的专业知识，并需要额外的培训和指导来 就这么做吧。他的总体职业目标是成为一名执行证据的独立调查员- 为老年人提供心理健康干预，该奖项将为弗洛雷斯-弗洛雷斯博士提供 为实现这一目标提供支持和培训。他组建了一支经验丰富的导师团队，包括： Jose Parodi博士[LMIC首席导师，老年病学和公共卫生，副教授(USMP)]；Joseph教授 加洛[美国混合方法研究首席导师，教授(JHSPH)]；Marina Piazza教授[共同导师， 实施科学，教授(UPCH)]；和William Checkley博士[共同导师，混合有效性- 执行研究设计，副教授(JHSPH)]。通过密切的指导相结合， 实践经验和关键课程，Flores-Flores博士建议完成以下培训 目标：1)实施科学培训；2)实验研究设计培训；3)高级 混合方法研究培训；2) 抑郁和焦虑症状在老年人中非常普遍，而且经常同时出现。 循证护理的存在是为了减少老年人的抑郁和焦虑症状。跨诊断 诸如问题解决疗法(PST)之类的方法已被证明是有效的，并已被 由世界卫生组织(WHO)推荐。然而，访问存在着无数的障碍 老年人的心理健康护理。因此，系统和有效地针对这些障碍的干预措施 都是迫切需要的。Flores-Flores博士建议调整、测试和改进多方面的干预策略 在秘鲁利马，为资源匮乏的老年人提供心理健康护理。他提议确定 通过社区卫生工作者提供精神卫生保健是否会有很高的接受度和改善 老年人的抑郁和焦虑症状。这项研究的结果将产生初步数据 争夺R01级奖项，以在多个项目中进行大型群集实施效果试验 并确定干预对抑郁/焦虑症状和其他健康的影响- 相关结果。

PROJECT SUMMARY/ABSTRACT This is an application to the K43 Fogarty Emerging Global Leader Award for Oscar Flores-Flores, MD, MSc. Dr. Flores-Flores has shown great promise as a young investigator and has experience conducting research in the epidemiology of aging and chronic diseases in low- and middle-income countries (LMICs). However, he is now proposing to gain expertise in implementation science and requires additional training and mentorship to do so. His overall career goal is to become an independent investigator in the implementation of evidence- based mental health care interventions for older adults, and this award will provide Dr. Flores-Flores with the support and training to accomplish this goal. He has assembled an experienced mentorship team including: Dr. Jose Parodi [Primary LMIC Mentor, geriatrics & public health, Associate Professor (USMP)]; Prof. Joseph Gallo [Primary U.S Mentor, mixed methods research, Professor (JHSPH)]; Prof. Marina Piazza [Co- Mentor, Implementation Science, Professor (UPCH)]; and Dr. William Checkley [Co-Mentor, hybrid effectiveness- implementation study Designs, Associate Professor (JHSPH)]. Through a combination of close mentorship, practical experience and key coursework, Dr. Flores-Flores proposes to accomplish the following training goals: 1) training in implementation science; 2) training in experimental study designs; and 3) advanced training in mixed-methods research; 2) Depression and anxiety symptoms are highly prevalent in older adults, and often present together. Evidence-based care exists to reduce depression and anxiety symptoms in older age. Trans-diagnostic approaches such as problem-solving therapy (PST) have been shown to be effective and have been recommended by the World Health Organization (WHO). However, there are myriad barriers to accessing mental health care in older adults. Thus, interventions that systematically and effectively target those barriers are urgently needed. Dr. Flores-Flores proposes to adapt, test, and refine a multi-faceted intervention strategy to deliver mental health care to older adults in low resource settings in Lima, Peru. He proposed to determine whether delivering mental health care via community health workers will have high uptake and will improve symptoms of depression and anxiety in older adults. Results from this study will generate preliminary data to compete for an R01-level award to conduct a large cluster implementation-effectiveness trial in multiple communities and determine the effect of the intervention on depressive/anxiety symptoms and other health- related outcomes.