The major goal of this Mentored Patient-Oriented Research Career Development Award submission is to further the applicant's experience as a clinical efficacy researcher who has examined the impact of treatment in a controlled setting, to that of an investigator who examines how well clinical interventions work in actual clinical care settings, and for whom and at what costs.
Specific aims, met through a detailed educational plan and research projects, are to: (I) develop the skills to measure access to care, health outcomes, and the economic cost of illness; (2) expand expertise in evaluating and implementing non-pharmacologic treatments; (3) improve the ability to develop, administer, and manage research investigations conducted in publicly funded mental health settings; and (4) develop sophistication in the design, measurement, and statistical analytic methods required for effectiveness research. The educational plan consists of formal course-work; videotape training sessions; consultative sessions and off-site visits with key leaders in the field of effectiveness and schizophrenia research; and performance of Applied Educational Activities. The research plan includes a randomized controlled trial of the effectiveness of Compliance Therapy (CT) vs. nonspecific counseling in outpatients with schizophrenia treated in clinics of the Dallas public mental health system. The proposed project would build on earlier effectiveness work involving CT by extending the study of this intervention from inpatients in England to public mental health center outpatients in the United States. Finally, this application outlines work that would provide more information on treatment effectiveness of CT by extending outcome domains to include patient preference/satisfaction, functioning, quality of life, and economic costs.
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