Estimating Population Effects of Mental Health interventions

描述（由申请人提供）：为确保使用最佳服务来改善公共卫生，我们需要知道这些服务在广泛人群中是有效的。加强对在现实环境中使用随机试验进行评估的服务的重视（“有效性”）是重要的一步。但试验中的受试者很少能代表感兴趣的目标人群。下一步是确定在试验中看到的结果是否可以推广到目标人群，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个研究计划，以确定何时以及如何推广有效性试验的结果。最初的重点将放在普遍的预防性干预措施上，以后再应用于其他领域。建议的培训重点是学习1)普遍预防干预措施的理论基础，特别是其效果的调节因素；2)随机试验的设计和实施，特别是如何选择受试者和背景，以及它们如何与目标人群不同；3)综合多项研究结果的现有方法，如荟萃分析和研究综合。该培训将在约翰霍普金斯大学彭博公共卫生学院进行，在一个极好的研究环境中，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估将用于开发这些方法。lalongo博士是这项工作的主要导师，Leaf博士是一名顾问。亨德里克斯·布朗博士是预防干预随机试验方面的专家，也是一位共同导师。研究的目的是开发方法，1)评估何时可以从随机试验推广到目标人群，2)估计在该人群中的效果。该K25将准备候选人领导该领域的未来工作，包括处理项目实施中的变化和为未来的试验设计制定指导方针。培训将是不可或缺的，以帮助候选人发展适当的方法。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.