This is a revised application for a Mentored Research Scientist Career Development Award (K01) entitled FACE-PC: Family-Centered Care for Older Adults with Depression and Chronic Medical Conditions in Primary Care. Dr. Mijung Park, the candidate, is a tenure-track Assistant Professor at the University of Pittsburgh, School of Nursing. Her career goals are to (1) improve the quality of care for older adults with multiple medical and psychosocial comorbidities and (2) become an independent researcher with expertise in comparative effectiveness trials conducted in real-world health care settings. Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families are already involved in various aspects of self-management of chronic disease in older adults. Despite the benefits they provide, informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts. Dr. Park's research targets patient- family dyads to optimize patients and their families' collective ability to self-manage chronic disease. Family is defined as kin and non-kin informal caregivers. Her mentors are Dr. Charles F. Reynolds III (primary mentor), Professor of Psychiatry, and the director of the NIMH-sponsored Advanced Center for Interventions and Services Research for Late-life Depression (ACISR) (P30 MH090333) and the Aging Institute of UPMC Senior Services and University of Pittsburgh and Dr. Kathryn R. Puskar (co-mentor), Professor of Nursing and an expert in dissemination and implementation of evidence-based psychosocial intervention. This K01 features two training objectives. Objective 1 is to attain expertise in developing and testing family-centered care program in the context of real-world health care settings. To meet this objective, Dr. Park plans on gaining hands-on training in quality improvement approaches as a method for intervention refinement (Objective 1a) and in conducting pragmatic clinical trials (Objective 1b). Objective 2 is to learn about approaches in dissemination and implementation sciences, with specific emphasis on implementing intervention. The purpose of the mentored research is to examine the feasibility and acceptability of the FACE-PC, a theory-driven, multi- component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease management.
It aims to optimize the patient and family's collective ability to self-manage chronic disease. We will first refine the study protocol, using rapid cycle quality improvement approaches (Aim 1). We will then pilot test FACE-PC using mixed-methods of pragmatic clinical trial design and qualitative methodology (Aim 2). The three sub-Aims are to examine the feasibility and acceptability (Aim 2a); determine if there is evidence of the hypothesized directional effect (Aim 2b); and elicit participants' experience with FACE- PC via face-to-face exit interviews (Aim 2c). Concurrently, we will explore the feasibility of the researc methods for the subsequent R01 (Aim 3).
More than 60% of older adults have multiple chronic conditions and prevalence of depression is significantly higher among those with multimorbidity. Untreated/undertreated depression can lead to devastating consequences in individuals with chronic medical conditions. Thus, there is an urgent need to develop a health care model that targets this serious public health problem.
|Park, Mijung (2017) In Sickness and in Health: Spousal Caregivers and The Correlates of Caregiver Outcomes. Am J Geriatr Psychiatry 25:1094-1096|
|Stahl, Sarah T; Rodakowski, Juleen; Saghafi, Ester M et al. (2016) Systematic review of dyadic and family-oriented interventions for late-life depression. Int J Geriatr Psychiatry 31:963-73|
|Degenholtz, Howard B; Park, Mijung; Kang, Yihuang et al. (2016) Variations Among Medicare Beneficiaries Living in Different Settings: Demographics, Health Status, and Service Use. Res Aging 38:602-16|
|Park, Mijung; Verhoeven, Josine E; Cuijpers, Pim et al. (2015) Where You Live May Make You Old: The Association between Perceived Poor Neighborhood Quality and Leukocyte Telomere Length. PLoS One 10:e0128460|