This application for an Advanced Center for lntervention Services Research (ACISR) focuses on enabling research that develops, evaluates, and disseminates interventions for depression and related disorders for older adults in primary and specialty medical and long term care settings. It utilizes both scientific advances and stakeholder input to generate new research and to translate findings into changes in practice. This application consists of four sections describing the Operations, Research Methods, Principal Research, and Network Development Cores. The section on the Operations Core describes the Governance of the Center, its three advisory boards (Scientific, Providers, and Stakeholders), Research Support Units (Biostatistics and Data Management, Assessment, and Intervention Management), the Education and Career Development Unit that includes the Center's T32 postdoctoral training program, and the Data and Safety Monitoring Unit, as well as descriptions of the processes, through which the Center develops new research. The section for the Research Methods Unit describes the product Engineering model for its activities, describes the Core's Intervention Development, Research Design, Qualitative Research Development and Assessment Development Groups. The Principal Research Core outlines the scientific Background and significance for our focus, major recent findings, ongoing and planned grants, and a series of pilot studies proposed to evaluate the feasibility, and estimate effect sizes to enable the design of new research. These pilot studies reflect a number of themes of the Center as a whole: the focus on both enabling research and investigator development; the use of qualitative as well as quantitative methods, and newer as well as standard experimental designs; the investigation of both psychotherapy and pharmacotherapy; the locus of studies with primary-, medical specialty- and long term care; and the design of studies to facilitate the evaluation of findings between--as well as within--comorbidities and clinical contexts. Finally, the Network Development Core proposes to develop an inner network of primary-care practices in greater Philadelphia that will serve as major research sites for the Center, and an outer Network based in the Maryland Academy of Family Physicians that will be the primary focus for our dissemination research.
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