Estimating Population Effects of Mental Health interventions

描述（由申请人提供）：为了确保最好的服务被用于改善公共卫生，我们需要知道这些服务在广泛的人群中是有效的。更加重视在现实环境中进行的随机试验评估的服务（“有效性”）是一个重要步骤。但试验中的受试者很少能代表感兴趣的目标人群。下一步是确定试验中观察到的结果是否适用于目标人群，正如最近的政府报告所强调的那样（NIMH，1999; IOM 2006）。指导定量研究职业发展奖（K25）将允许统计学家伊丽莎白·斯图尔特博士制定一项研究计划，以确定何时以及如何推广有效性试验的结果。最初的重点将是普遍预防性干预措施，随后将适用于其他领域。拟议的培训侧重于学习1）普遍预防干预措施的理论基础，特别是其效果的调节剂，2）随机试验的设计和实施，特别是如何选择受试者和背景以及它们与目标人群的差异，以及3）现有的方法结合多项研究的结果，如荟萃分析和研究综合。这项培训将在约翰霍普金斯布隆伯格公共卫生学院进行，在一个良好的研究环境中，有两个预防研究中心：NIMH/NIDA资助的预防和早期干预中心（PI：Nicholas lalongo博士）和CDC资助的预防青少年暴力中心（PI：Philip Leaf博士）。这两个中心正在进行的评价将用于开发方法。拉隆戈博士是这项工作的主要导师，利夫博士是顾问。C医生亨德里克斯·布朗是一位预防干预随机试验的专家，他是一位共同导师。研究目标将开发方法，以1）评估何时可能从随机试验推广到目标人群，以及2）估计该人群的效果。该K25将为候选人领导该领域的未来工作做好准备，包括处理项目实施中的变化和为未来试验设计制定指南。培训将是不可或缺的，以帮助候选人制定适当的方法。由此产生的方法和结果将对公共卫生产生广泛影响，确保最有效的精神卫生服务得到广泛实施。

DESCRIPTION (provided by applicant): To ensure that the best services are being used to improve public health we need to know that those services are effective across broad populations. Increased emphasis on services that have been evaluated using randomized trials carried out in real-world settings ("effectiveness") is one important step. But the subjects in trials are rarely representative of the target population of interest. A next step is to determine whether the results seen in a trial generalizes to the target population, as highlighted in recent government reports (NIMH, 1999; IOM 2006). The Mentored Quantitative Research Career Development Award (K25) will allow Dr. Elizabeth Stuart, a statistician, to develop a program of research to determine when and how results of effectiveness trials can be generalized. The initial focus will be on universal preventive interventions, with later application to other areas. The proposed training focuses on learning about 1) the theory underlying universal preventive interventions, particularly moderators of their effects, 2) the design and implementation of randomized trials, especially how subjects and contexts are selected and how they may differ from the target population, and 3) existing methods for combining results from multiple studies, such as meta-analysis and research synthesis. This training will be done at Johns Hopkins Bloomberg School of Public Health, in an excellent research environment with two prevention research centers: the NIMH/NIDA funded Center for Prevention and Early Intervention (PI: Dr.Nicholas lalongo), and the CDC funded Center for the Prevention of Youth Violence (PI: Dr. Philip Leaf). Ongoing evaluations at these two centers will be used to develop the methods. Dr. lalongo is the primary mentor for this work, and Dr. Leaf is a consultant. Dr. C. Hendricks Brown, an expert in randomized trials of preventive interventions, is a co- mentor. The research aims will develop methods to 1) assess when generalization from a randomized trial to a target population is possible, and 2) estimate the effect in that population. This K25 will prepare the candidate to lead future work in this area, including handling variation in program implementation and developing guidelines for future trial design. The training will be integral to help the candidate develop appropriate methods. The resulting methods and results will have broad implications for public health, ensuring that the most effective mental health services are being widely implemented.