The Network Development Core of this ACISR, directed by Dr. Joseph Gallo, houses the infrastructure support for the intervention and dissemination studies of the Center. The network development activities include: 1) seeking input and setting the agenda from stakeholders; 2) network building, which includes recruitment of practices; 3) capacity building to obtain practice and patient level data; 4) dissemination of findings and planning next steps. We propose to work with two sets of practices. Clinical Care Associates (CCA) represents approximately 52 community-based, urban and suburban primary-care practices that have participated in federally funded research on the mental health of older primary-care patients directed by ACISR investigators. This Network Core also builds on the continuing collaboration between the Network Core Principal Investigator and a state-wide community organization of 700 mostly non-academic family physicians (the Maryland Academy of Family Physicians). The CCA sites would serve as a site for the activities of the Principal Research Core and for developing R01's on intervention research (i.e., act as a-test sites for intervention development) while the Maryland Academy of Family Physicians (MAFP) would be the focus of technology transfer, dissemination, and product re-engineering activities of the ACISR (i.e., act as b-test sites to assess acceptability of interventions to patients and physicians, sustainability, and dissemination strategies), and would be the sites for developing R01's on practice, dissemination, and services research. These partners provide us with a diversity of characteristics at the level of the community (e.g., rural, suburban, urban), patient (e.g., ethnicity and medical comorbidity), and provider (e.g., variable interest in depression and in knowledge about the mental disturbances of late-life). One set of practices (CCA) can serve as a focal point for intervention development while the other (MAFP) is well-suited to study the dissemination of innovations. The practices will be linked through the Network Development Core to the Operations, Methods, and Principal Research Cores of this ACISR.
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