This application requests five years of support for Raymond L. Ownby, MD, PhD, to pursue research and training in applied cognitive aging and human factors research as applied to patient- oriented research. Through mentoring by Sara J. Czaja, PhD, Dr. Ownby will not only develop expertise in applying skills in these areas to a critical problem (medication adherence in elderly patients with memory deficits) but will also create a center for evidence-based practice in geriatric mental health. The research study to be completed during the period of support will use two information technology interventions to improve patients' adherence with medication regimens. Base on a model of adherence to medical treatment developed by Park and Jones (1997), information interventions will target key points in the medication adherence process. Pilot research has suggested that this model is valid for use with the patient population of this study (elderly patients with memory problems who either have or are at risk for developing Alzheimer's disease). During the last two years of support, Dr. Ownby will develop a research proposal drawing on results of the research study to develop a large-scale multicenter clinical trial of information technology interventions for adherence in other geographical sites and with other patient populations. It is anticipated that this application will seek funding through the RO1 mechanism. The professional development program to be followed by Dr. Ownby comprises regular meetings with Dr. Czaja, work on the proposed research study, didactic coursework, workshops, and seminars in the areas of human factors, information technologies, statistics, research design, evidence-based practice, and the responsible conduct of research. Through regular meetings and research supervised by his mentor and regular meetings with co-mentors, Dr. Ownby will be able to integrate his professional experience as a clinical psychiatrist and neuropsychologist with didactic training in human factors and applied cognitive aging to create novel strategies to improve patient adherence, to develop a large-scale clinical trial of these strategies, and to apply principles of evidence-based practice to develop a Center for Evidence- Based Practice at the University of Miami. This center's mission will be to disseminate research findings in geriatric mental health through systematic reviews, meta-analyses~ and treatment guidelines made available through traditional publication routes and the World Wide Web. The Center will foster new research in applications of information technologies to the mental health problems of the elderly and provide leadership and training in applying information to clinical practice. The professional development program will thus allow Dr. Ownby to develop expertise in creating information technology applications for use in healthcare with the elderly, provide him with key tools in designing and carrying out large-scale Clinical trials, and enable him to use results of research studies to guide clinical practice in geriatrics. The period of proposed support will thus allow Dr. Ownby to develop as a clinical researcher capable of carrying out patient-oriented research studies and give him additional tools in applied cognitive aging and human factors research, especially applications of emerging information.
