The goal of this proposed Home Care Intervention and Practice Research Infrastructure Program (RISP) is to develop research aimed at improving the treatment and outcomes of depression in elderly patients receiving home health care. The application requests funding for conceptual, methodological, and site development of depression intervention research in geriatric home care. Our group brings the following critical experiences: 1. Generation of social, clinical, and biological findings; 2. Development and application of clinical and public health methodologies; and 3. Transfer of findings and methods into community practice, including primary care and home care. This application is a natural progression from our epidemiologic research which has found a high prevalence of major depression in these patients. Despite the availability of efficacious treatments, the great majority of home care patients receive no treatment for their depression. We plan to implement RISP initiatives in partnership with the three largest home care agencies serving Westchester County, NY. The overall aim will be pursued through three specific initiatives selected to facilitate and accelerate the rate of conceptual growth, methodological sophistication, and agency infrastructure development required for advancing depression research in home care: 1. Collaborate in developing, implementing, and evaluating training aimed at improving the detection of depression; 2. Collaborate to ensure timely access to the agency's patient population and its clinical data for purposes of implementing study designs; 3. Promote research development in home care by: a. Designing and conducting R01-quality intervention research based upon already completed studies, and b. Designing and implementing home care intervention pilots that test the feasibility, acceptability, and potential impact of interventions aimed at improving the treatment and outcomes of depression. Sample interventions include: 1) electronic depression management guidelines; 2) nurse communication skills training; and 3) telephone depression management. Cornell's Home Care RISP comes at a critical juncture in the development of effective interventions for depression in this often ignored sector of the health care system. The RISP is designed to build upon our knowledge and experience in home care research by applying conceptual and methodological advances from related fields. We expect this combination of skills and experience working in partnership with home care agencies will maximize the speed and depth of our capacity to develop depression intervention research in home care and improve patient care and outcomes of depression.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Resource-Related Research Projects (R24)
Project #
5R24MH064608-04
Application #
6824873
Study Section
Special Emphasis Panel (ZMH1-CRB-J (04))
Program Officer
Oliver, Karen Anderson
Project Start
2001-12-18
Project End
2006-11-30
Budget Start
2004-12-01
Budget End
2005-11-30
Support Year
4
Fiscal Year
2005
Total Cost
$570,550
Indirect Cost
Name
Weill Medical College of Cornell University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
060217502
City
New York
State
NY
Country
United States
Zip Code
10065
Bruce, Martha L; Raue, Patrick J; Reilly, Catherine F et al. (2015) Clinical effectiveness of integrating depression care management into medicare home health: the Depression CAREPATH Randomized trial. JAMA Intern Med 175:55-64
Reifler, Burton V; Bruce, Martha L (2014) Home-based mental health services for older adults: a review of ten model programs. Am J Geriatr Psychiatry 22:241-7
Jayasinghe, Nimali; Rocha, Leila P; Sheeran, Thomas et al. (2013) Anxiety symptoms in older home health care recipients: prevalence and associates. Home Health Care Serv Q 32:163-77
Pickett, Yolonda Renee; Weissman, Judith; Bruce, Martha L (2012) Racial differences in antidepressant use among older home health care patients. Psychiatr Serv 63:827-9
Brown, Ellen L; Bruce, Martha L (2011) Thank you, CMS, for your leadership! Res Gerontol Nurs 4:78-9
Bruce, Martha L; Sheeran, Thomas; Raue, Patrick J et al. (2011) Depression care for patients at home (Depression CAREPATH): intervention development and implementation, part 1. Home Healthc Nurse 29:416-26
Sheeran, Thomas; Rabinowitz, Terry; Lotterman, Jennifer et al. (2011) Feasibility and impact of telemonitor-based depression care management for geriatric homecare patients. Telemed J E Health 17:620-6
Raue, Patrick J; Weinberger, Mark I; Sirey, Jo Anne et al. (2011) Preferences for depression treatment among elderly home health care patients. Psychiatr Serv 62:532-7
Brown, Ellen L; Raue, Patrick J; Roos, Bernard A et al. (2010) Training nursing staff to recognize depression in home healthcare. J Am Geriatr Soc 58:122-8
Sheeran, Thomas; Byers, Amy L; Bruce, Martha L (2010) Depression and increased short-term hospitalization risk among geriatric patients receiving home health care services. Psychiatr Serv 61:78-80

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