ALACRITY for Late- and Mid-Life Mood Disorders

快捷性中心摘要 老年人口的快速增长(预计到2020年美国将增加73%)以及疾病和 使他们的护理复杂化的残疾使这一领域的研究成为国家优先事项。我们关注的是中老年 情绪障碍，因为它们是残疾的主要原因，增加了医疗发病率和死亡率， 造成痛苦，增加护理成本。药物疗法解决了不超过一半的人的需求 这些人和大多数非药物疗法都很复杂，可伸缩性和覆盖范围有限。 我们建议实施一种基于部署的行为干预的新模式，并 根据神经生物学模型简化实施，并通过移动技术进行增强。宁可 而不是只关注可用干预措施的吸收和可持续性，其中许多干预措施过于 对于社区使用，我们正在努力简化治疗本身并改进其 送货。因此，我们的模型：1)以消费者、社区合作伙伴和我们的 一队。2)与社区合作伙伴和跨学科团队共同制定干预措施，并使用 神经生物学概念作为简化行为干预的“简化规则”，以便它们能够 由社区临床医生使用；3)在评估中将移动技术整合到社区干预中， 干预措施和遵守监测水平；以及4)在社区站点测试其干预措施 社区临床医生缩短吸收和可持续发展的途径。为了最大限度地发挥我们的影响力，我们将努力 无论是在大多数老年人和中年人接受护理(初级保健)的环境中还是在环境中 为有特殊临床(虐待老年人)和社会需求(贫困)的人提供服务。该中心的方法 与传统的干预和服务研究明显背道而驰，可以带来革命性的变化 现场如何看待T2干预在社区中的开发和部署。 我们的方法核心将为中心的项目提供质量控制，作为创新的孵化器 寻求新的设计和分析方法，以提高有效性数据的信息产量。它 还使用大数据来帮助识别需要新干预措施的人口，提供政策 支持和整合新的移动技术方法进行社区干预。核心还将 评估该中心在实地的生产力和影响，并传播其方法上的进步。 我们有信心迎接这项工作的挑战，因为我们共同工作了20年 与利益相关者和社区合作伙伴一起参与干预计划和实施，由4人提供支持 NIMH连续资助的中心赠款，大量独立资助的研究项目，以及强大的 初级调查员的研究、培训和职业发展记录。

ALACRITY CENTER ABSTRACT The rapid increase of older persons (73% increase anticipated in US by 2020) and the diseases and disabilities complicating their care make research in this area a national priority. We focus on late- and mid-life mood disorders because they are the leading cause of disability, increase medical morbidity and mortality, cause suffering, and increase the cost of care. Pharmacotherapy addresses the needs of no more than half of these persons and most non-pharmacological therapies are complex and have limited scalability and reach. We propose to put into action a novel model of deployment-based behavioral interventions and implementation, streamlined based on neurobiology models and augmented by mobile technology. Rather than focusing exclusively on uptake and sustainability of available interventions, many of which are too complex for community use, we are working to both simplify the treatments themselves and improve their delivery. Accordingly, our model: 1) Targets groups identified by consumers, community partners, and our team. 2) Develops its interventions jointly with community partners and a transdisciplinary team and uses neurobiological concepts as a “simplification rule” for streamlining behavioral interventions so that they can be used by community clinicians; 3) integrates mobile technology to community interventions at the assessment, the intervention, and the adherence monitoring levels; and 4) tests its interventions at community sites using community clinicians to shorten the way to uptake and sustainability. To maximize our impact, we will work both in settings in which most older and middle-aged people receive care (primary care) and in settings serving persons with special clinical (elder mistreatment) and social needs (poverty). The Center's approach is a clear departure from traditional intervention and services research and can lead to a revolutionary change in how the field thinks about T2 intervention development and deployment in the community. Our Methods Core will provide quality control for the Center's projects, serve as an incubator for innovative approaches to novel design and analytic methods that enhance the information yield of effectiveness data. It also uses big-data to aid the identification of populations in need of novel interventions, provides policy support, and integrates novel mobile technology approaches to community interventions. The Core will also evaluate the Center's productivity and impact on the field and disseminate its methodological advances. We are confident that we can meet the challenges of this work because of our 20 years of working together with stakeholders and community partners in intervention planning and implementation supported by 4 consecutive NIMH-funded Center grants, a large portfolio of independently funded studies, and a strong record of research training and career development of junior investigators.