This application establishes the Asian American Center on Disparities Research (AACDR). AACDR builds upon a program of research on the mental health issues of Asian American populations that had been carried on since 1988 by the National Research Center on Asian American Mental Health (NRCAAMH). AACDR pursues a research agenda that investigates how cultural factors work to either enhance or mitigate the implementation and effectiveness of evidence-based treatments for Asian American clients. The center's objectives are to (1) conduct programmatic, problem-oriented research toward the empirical testing of effective clinical ? treatments for Asian American populations; (2) conduct research that has theoretical and policy significance for Asian Americans in particular and the mental health field in general; (3) promote and conduct research that addresses key methodological issues involved in the study of diversity and disparities; (4) be the focal point and stimulus for researchers conducting Asian American disparities research on a national level by maintaining and enhancing a network of researchers, service providers, and policy makers to facilitate theory and methodology development; and (5) bridge science into mental health practice, in particular, concerning cultural influences that affect critical problems of treatment and service delivery such as medical non-adherence and premature dropout. The center's Clinical Effectiveness Research Program tests the effectiveness of evidence-based treatments for depression for Asian American clients and identifies the cultural variables that moderate the effects of these interventions. The Therapist Factors Research Program determines if therapist characteristics associated with cultural competence and the use of evidence-based practices interact or independently affect treatment outcomes for mental health outpatient clients. The Medication Adherence Research Program develops and tests the effectiveness of a culturally targeted intervention designed to improve medication adherence among depressed Asian American clients. Disparities in health care refer to the differential treatment of patients on the basis of race or ethnicity that is not explained by underlying health conditions or treatment preferences of patients (Institute of Medicine, 2002). Since 1978, various presidential commissions have concluded that the disparities were not so much due to racial and ethnic differences in rates of psychopathology but were due to inaccessible and ineffective treatment. Thus, one critical task is to improve therapeutic effectiveness and quality of care for these clients. Essentially, the center's research mission is devoted to and focused on this latter aspect of disparity-cultural factors that affect the effectiveness of treatment. ? ? ?
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