The ACISR/LLMD focuses on a series of scientific themes that represent our vision of the areas in which the treatment of late life mood disorders must be advanced in the next five years. Research Methods will provide the infrastructure to support the development of novel, innovative methodologies to address the research issues and goals that emerge from these themes. Thus, we RMC will forge the methodologic bridges between the Center's themes, on the one hand, and research that must be accomplished to address those themes. An equally important goal is to contribute to pro qress of the science of mental health interventions and services research in applied settings. We will accomplish these objectives through four specialized but interacting Units: 1. The Assessment of Outcomes Unit (Dew, Nebes, Lenze) will focus on development, evaluation and application of outcomes-based methodologies appropriate for community-based effectiveness interventions. In particular, the unit will address assessment dilemmas within three areas of comorbidity that are ubiquitous """"""""cotravelers"""""""" with late life mood disorders: cognitive impairment, physical disability, and health-related quality of life. 2. The Research Design and Biostatistics Unit (Mazumdar, Dew) will address a series of key difficulties that arise as traditional randomized clinical trials methodologies in late life intervention research are'_translated"""""""" to previously understudied groups and applied settings. These difficulties involve the evaluation of multiple endpoints and subgroups of interest, nonignorably missing data, and the use of """"""""response-adaptive"""""""" allocation research designs. 3. The Pharmacotherapy Adherence Unit (Bies, Pollock, Brown) will evaluate and adapt novel approaches to capture medication adherence patterns in late life populations. Key goals are the evaluation of alternative assessment approaches and development of new adherence measures and metrics in applied settings. 4. The Intervention Portability, Effectiveness, and Dissemination Unit (Schulz, Detlefsen) will focus on the composition and generalizability of the intervention strategies themselves. Strategies to decompose interventions to determine which elements exert the most impact, and strategies to disseminate effective interventions and their components will be developed and tested. Units will be composed of multidisciplinary teams that will each pursue activities at two levels of function: direct research investigation of new tools and approaches; and dissemination and training efforts, both within and beyond the Center.
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