The Mentored Scientist Award for New Minority Faculty will allow me to develop the research skills and experience necessary to become an independent investigator in special populations of geriatric mentally ill patients. Having obtained a Master of Public Health degree during previous training, I have a solid foundation in the basics of health services, epidemiology, and biostatistics but have limited experience in designing and implementing treatment interventions. My specific career goals are to move from an investigator who has performed descriptive studies utilizing existing data sets to being able to design, implement and evaluate interventions for mentally ill nursing home residents. The centerpiece of my development and training activities will be individual mentorship and consultation from an interdisciplinary, nationally recognized group of investigators with expertise in treatment of geriatric depression, translating efficacy based research into effective collaborative care interventions in other primary care settings, development and implementation of psychosocial interventions useful even in cognitively impaired elders. This will be augmented by some group mentorship from geriatric psychiatry experts via the Summer Research Institute in Geriatric Psychiatry, and a few selected courses in Health Services and Biostatistics.
The aims of the proposed research project are to: 1) develop and implement a multifaceted interdisciplinary collaborative care model for identification and treatment of major depression in nursing home residents; 2) test the hypotheses that collaborative care versus usual care leads to greater improvement in a) the quality of antidepressant care, b) in clinical symptoms including severity of depression and weight loss, c) patient satisfaction with care: 3) explore means of comparing pain severity, functional Activities of Daily Living, quality of life, and nursing home resource utilization for patients under usual care vs. collaborative care. This will be done in a prospective, controlled trial of this model vs. usual care in several community nursing homes. I anticipate that the knowledge and experience gained developing and evaluating an effective intervention for depression in this setting will be useful in longer-term career goals to effectively treat other prevalent mental disorders in geriatric patients in and outside the nursing home setting.
