African Americans with major depressive disorder (MDD) have greater disease burden, receive lower quality care, and under-utilize traditional mental health services compared to white Americans with MDD. Because clergy are regarded as trusted "gatekeepers," they are the primary source of mental health education and/or services for socioeconomically diverse African Americans. However, few studies investigate how to translate evidence-based practices (EBPs) for depression into faith-based settings. This K23 proposes a concurrent, mixed-methods study to investigate the feasibility and acceptability of utilizing a community-partnered participatory research (CPPR) approach to support clergy in implementing Interpersonal Counseling (IPC) in faith-based settings. IPC is a manualized, 3-session depression intervention that was designed for delivery by non-mental health professionals, such as clergy.
We aim to contribute an understanding of the factors involved in translating EBPs into real world settings, knowledge that could be used to disseminate interventions to underserved populations and reduce health disparities. This study has three main phases. The first phase (Vision) is designed to initiate a community-partnered approach to plan how to implement IPC in faith-based settings. It will yield a Community Steering Council that will guide all research activities and develop a specific implementation strategy for clergy. The second phase (Valley) is the implementation of a CPPR informed model to test the feasibility and acceptability of training 8 clergy in IPC at two African American churches. Implementation will be staggered across churches to incorporate community input. Patient outcomes will be depressive symptomatology and level of functioning. Implementation outcomes will be feasibility, acceptability, adoption, implementation, and maintenance. The third phase (Victory) will allow community members to provide feedback on the study design and celebrate results. Execution of these studies will be combined with a comprehensive training program that integrates didactic lectures with mentored experiences. Led by co-mentors, Dr. Myrna Weissman, Dr. Ken Wells, and Ms. Loretta Jones, the application encompasses the following career training goals: (1) to learn and apply principles of dissemination and implementation science (Drs. Lisa Dixon, Sherry Glied, Gail Wyatt, and Helen Verdeli);(2) to develop expertise in community engagement (Dr. Alfiee Breland-Noble, Dr. Alwyn Cohall, and Mr. Richard Ferreira);and (3) to gain skills in mixed-methods (qualitative/quantitative) study designs (Drs. Jennifer Wisdom, Mindy Fullilove, and Priya Wickramaratne). The research plan produces data for a R01 to conduct a cluster-randomized controlled trial to test different ways to implement IPC in faith-based settings.
This K23 Career Development Award prepares the candidate to develop an independent program of research focused on the implementation of evidence-based practices (EBPs) in faith-based settings to reduce racial/ethnic disparities in depression treatment. This research wil advance the NIMH strategic plan by incorporating the needs of diverse people with mental illness (Objective 3) and strengthening the public health impact of NIMH supported research (Objective 4). It also addresses the NIMH Division of Services and Intervention Research (DSIR) area of high priority to employ strategic partnerships and community engagement/participation to enhance research capacity and infrastructure to conduct research in underserved and diverse populations.