Comparative Effectiveness of Interventions for Depression in the Community

这个独立研究科学家奖申请的目标是保护必要的时间，以进一步发展我的技能，作为一个新的独立研究人员，专门从事社区精神卫生系统中抑郁症干预措施的比较有效性。这个奖项将使我成为一个复杂的比较有效性研究人员利用国家的最先进的方法和统计方法来研究干预措施在减轻高度公共卫生优先精神健康障碍的有效性。我的研究计划和计划的职业发展活动是基于医学研究所比较有效性研究优先委员会制定的比较有效性研究的定义。我的目标是与专家顾问合作，并参加培训活动，将我的比较有效性研究计划提升到一个新的水平。为了补充我目前的研究计划，评估社区精神卫生系统中抑郁症干预措施的有效性，为人群水平的临床决策提供信息，我的目标是发展方法和统计方法方面的专业知识，使我的研究能够解决如何有效传播有效干预措施以满足个人消费者对抑郁症服务的需求这一重要问题。这个奖项将为我提供所需的时间来参与课堂教学中的最新统计方法，参加培训研讨会和研究所，与专家顾问合作，并参加会议，以提高我的发展作为一个比较有效的研究人员。该奖项也将使我有时间，专家咨询和教育需要进行两项重要的研究，以告知社区抑郁症干预措施的有效传播：治疗有效性的患者基线调节剂的研究和医疗保健利用率的研究以及与社区精神卫生系统中MDD的心理健康干预措施的利用相关的成本。本研究的具体目的包括：1）评估患者基线技能缺陷是否会调节在社区精神卫生环境中接受治疗的重度抑郁症患者的动态治疗和认知治疗的有效性，2）评估患者基线技能缺陷是否会调节动态治疗和认知治疗对次要结局指标的有效性，3）探索其他基线患者变量，这些变量可能会调节在社区精神卫生环境中治疗的重度抑郁症患者的这些心理治疗方法的有效性，和4）评估社区精神卫生系统中接受心理治疗的抑郁症患者的医疗保健利用率和相关费用，接受替代治疗的患者。

DESCRIPTION (provided by applicant): The goal of this independent research scientist award application is to protect the time necessary to further develop my skills as a newly independent researcher specializing in comparative effectiveness of interventions for depression in the community mental health system. This award would allow me to become a sophisticated comparative effectiveness researcher utilizing state-of-the-art methodologies and statistical approaches to study the effectiveness of interventions in alleviating mental health disorders of high public health priority. My program of research and planned career development activities are based on the definition of comparative effectiveness research elaborated by the Institute for Medicine's Committee on Comparative Effectiveness Research Prioritization. It is my goal to work with expert consultants and participate in training activities to take my comparative effectiveness research program to the next level. To complement my current program of research evaluating the effectiveness of interventions for depression in the community mental health system that inform clinical decision making at the population level, my goal is to develop expertise in methods and statistical approaches that would allow my research to address the important question of how to efficiently disseminate effective interventions to meet the needs of individual consumers of services for depression. This award would afford me the time needed to participate in classroom instruction in the newest statistical approaches, attend training seminars and institutes, work with expert consultants, and attend conferences to enhance my development as a comparative effectiveness researcher. This award would also allow me the time, expert consultation, and education needed to conduct two important studies to inform the efficient dissemination of interventions for depression in the community: a study of the patient baseline moderators of treatment effectiveness and a study of healthcare utilization and costs associated with the utilization of mental health interventions for MDD in the community mental health system. The specific aims of this investigation include 1) to assess whether patient baseline skills deficits moderate the effectiveness of dynamic therapy and cognitive therapy for patients with major depressive disorder treated in the community mental health setting, 2) to assess whether patient baseline deficits moderate the effectiveness of dynamic therapy and cognitive therapy on secondary measures of outcome, 3) to explore additional baseline patient variables that may moderate the effectiveness of these psychotherapeutic approaches for patients with major depressive disorder treated in the community mental health setting, and 4) to evaluate healthcare utilization and associated costs for patients treated with psychotherapy for depression in the community mental health system compared to patients who receive alternative treatments.