ALACRITY for Late- and Mid-Life Mood Disorders

活力中心摘要 老年人的迅速增加（预计到2020年美国将增加73%）以及疾病和 残疾使其护理复杂化，因此这方面的研究成为国家优先事项。我们专注于晚年和中年 情绪障碍，因为它们是残疾的主要原因，增加医疗发病率和死亡率， 造成痛苦，增加医疗费用。药物治疗解决了不超过一半的需求， 这些人和大多数非药物治疗是复杂的，并且具有有限的可扩展性和范围。 我们建议将一种基于部署的行为干预的新模型付诸行动， 它是一种基于神经生物学模型并通过移动的技术增强的简化实现。而 而不是仅仅关注现有干预措施的吸收和可持续性，其中许多干预措施也 复杂的社区使用，我们正在努力既简化治疗本身，并提高其 交付.因此，我们的模型：1）目标群体由消费者，社区合作伙伴和我们的 团队2)与社区合作伙伴和跨学科团队共同制定干预措施， 神经生物学概念作为简化行为干预的“简化规则”， 由社区临床医生使用; 3）在评估时将移动的技术集成到社区干预中， 干预措施和依从性监测水平;以及4）使用 社区临床医生，以缩短吸收和可持续性的方式。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， 为有特殊临床（虐待老人）和社会需要（贫困）的人提供服务。中心的做法 是对传统干预和服务研究的一个明显的背离， 在该领域如何看待T2干预的发展和部署在社区。 我们的方法核心将为中心的项目提供质量控制， 新的设计和分析方法，提高有效性数据的信息产量的途径。它 还使用大数据来帮助识别需要新干预措施的人群， 支持并将新的移动的技术方法纳入社区干预措施。核心也将 评估该中心的生产力和对该领域的影响，并传播其方法的进步。 我们有信心，由于我们20年的共同努力，我们能够迎接这项工作的挑战 与利益攸关方和社区合作伙伴一起规划和实施干预措施， 连续NIMH资助的中心赠款，独立资助的研究的大组合，以及强大的 初级研究者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.