A 2012 Institute of Medicine study concludes that the older adult mental health and substance abuse workforce is woefully inadequate, and the future near doubling of the number of older adults in need of mental health services will entirely overwhelm existing capacity and services without major innovations in the development, dissemination, implementation, and delivery of services. This application requests renewal funding for a postdoctoral training program in geriatric mental health services research designed to equip the next generation of researchers with the skills to address this challenge through a novel, multi-site training program including Dartmouth College (Stephen Bartels), Cornell University (Martha Bruce), University of Washington (Jrgen Untzer) and the University of Michigan (Frederic Blow). We will achieve this goal by providing 20 post-doctoral fellows a two to three year program consisting of: mentored geriatric mental health services research training; cross-site seminars and co-mentoring linked by web-based communication and archived curricula; and formal coursework at each site. Applicants will have a doctoral degree in medicine, psychology, social work, sociology, epidemiology, public health, health economics, or a related social science. The proposed renewal builds on a proven track record of success, including recruitment of participants from underrepresented minorities (32%) and disabled (12%) with diverse backgrounds (including MDs and PhDs, psychologists, social workers, nurses and dieticians); 100% retention over the 2-3 year fellowship (except for 4 fellows who successfully obtained faculty positions and left the program early); a successful web-based, biweekly, cross-site mentoring seminar; and evidence of productive scholarship and career advancement. In the 9 years of our program, 25 fellows have produced over 560 abstracts, posters, presentations, book chapters, and articles, including 210 peer-reviewed journal articles (97 as first author), and 34 book chapters. Among the 19 fellows graduating in the first seven years of the program three-quarters (74%) have obtained grant funding, including half (47%) obtaining NIH-supported grants, with a quarter (24%) consisting of NIMH K awards. Ninety-five percent of all of our graduates have obtained academic or research positions. In this renewal we will further enhance this novel program by: extending its reach and impact through a national webinar series including early career geriatric mental health researchers outside of the four fellowship sites; enhancing the infrastructure of the program by adding four associate training directors; supporting skills in team science through cross-site collaborative projects, and by skill development related to new NIMH priorities including maximizing population health impact through dissemination and implementation research; measuring intervention mechanisms of action (moderators, mediators, fidelity); reducing disparities in service use and outcomes; improving reach and access through eHealth and mHealth technology; leveraging existing data bases and electronic medical records; and in depth training in the responsible conduct of research.
This training program responds to a nationally recognized urgent need to develop new researchers who have the necessary skills to inform the development, dissemination, and implementation of future mental health and substance abuse services for a rapidly growing older population. Four research centers of excellence will work together to train 20 post-doctoral fellows by providing web-based seminars and mentored research opportunities over the next five years of funding.
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