DEPRESSION AND MEDICAL CARE:AGING AND CLINICAL SETTING

描述(由申请人提供)：本申请为发明服务研究高级中心(ACISR)，重点是促进研究，开发、评估和传播初级和专科医疗和长期护理环境中针对老年人的抑郁症和相关疾病的干预措施。它利用科学进步和利益相关者的投入来产生新的研究，并将发现转化为实践中的变化。本申请由四个部分组成，描述了运营、研究方法、主要研究和网络开发核心。运营核心部分介绍了中心的治理、其三个咨询委员会(科学、提供者和利益相关者)、研究支持单位(生物统计和数据管理、评估和干预管理)、教育和职业发展单位(包括中心的T32博士后培训计划)以及数据和安全监测单位，并描述了中心开展新研究的流程。研究方法单元的部分描述了其活动的产品工程模型，描述了核心的干预开发、研究设计、定性研究开发和评估开发小组。主要研究核心概述了我们重点研究的科学背景和意义、最近的主要发现、正在进行和计划中的拨款，以及建议进行的一系列试点研究，以评估可行性，并估计效果大小，以便能够设计新的研究。这些试点研究反映了该中心作为一个整体的若干主题：注重促进研究和研究人员的发展；使用定性和定量方法以及较新的和标准的实验设计；调查心理治疗和药物治疗；初级、医学、专科和长期护理的研究中心；以及设计研究以促进对--以及--合并症和临床环境中的研究结果的评估。最后，网络发展核心建议在大费城建立一个初级保健实践的内部网络，作为该中心的主要研究地点，并在马里兰家庭医生学院建立一个外部网络，作为我们传播研究的主要重点。

DESCRIPTION (provided by applicant): This application for an Advanced Center for lntervention Services Research (ACISR) focuses on enabling research that develops, evaluates, and disseminates interventions for depression and related disorders for older adults in primary and specialty medical and long term care settings. It utilizes both scientific advances and stakeholder input to generate new research and to translate findings into changes in practice. This application consists of four sections describing the Operations, Research Methods, Principal Research, and Network Development Cores. The section on the Operations Core describes the Governance of the Center, its three advisory boards (Scientific, Providers, and Stakeholders), Research Support Units (Biostatistics and Data Management, Assessment, and Intervention Management), the Education and Career Development Unit that includes the Center's T32 postdoctoral training program, and the Data and Safety Monitoring Unit, as well as descriptions of the processes, through which the Center develops new research. The section for the Research Methods Unit describes the product Engineering model for its activities, describes the Core's Intervention Development, Research Design, Qualitative Research Development and Assessment Development Groups. The Principal Research Core outlines the scientific Background and significance for our focus, major recent findings, ongoing and planned grants, and a series of pilot studies proposed to evaluate the feasibility, and estimate effect sizes to enable the design of new research. These pilot studies reflect a number of themes of the Center as a whole: the focus on both enabling research and investigator development; the use of qualitative as well as quantitative methods, and newer as well as standard experimental designs; the investigation of both psychotherapy and pharmacotherapy; the locus of studies with primary-, medical specialty- and long term care; and the design of studies to facilitate the evaluation of findings between--as well as within--comorbidities and clinical contexts. Finally, the Network Development Core proposes to develop an inner network of primary-care practices in greater Philadelphia that will serve as major research sites for the Center, and an outer Network based in the Maryland Academy of Family Physicians that will be the primary focus for our dissemination research.