This application is in response to the NIMH program announcement """"""""Intervention and Practice Research Infrastructure Program"""""""" {IP-RISP; PAR -04-015). We propose a collaborative partnership between a research center (Center for Applied Research on Aging and Health, CARAH) at Thomas Jefferson University, and a senior center in the Philadelphia Region, Center in the Park (CIP). CIP is a certified senior center. It has received numerous awards for its innovative programming for the 6,000 community-living urban elders it serves; over 85% of whom is African American. Building on our existing collaborative platform, we plan to implement a partner program, entitled """"""""In Touch: Mind, Body and Spirit"""""""". The overall goal of this program is to create a sustainable infrastructure in a community setting for systematic mental health research, programming and its evaluation and research training that is responsive to the social and cultural tenets of the target group. The partnership is guided by a well-established collaborative model and is based in the tradition of action science in that it seeks to develop a """"""""community of inquiry"""""""" within a """"""""community of practice."""""""" It employs multimethodologies to evaluate infrastructure viability and sustainability and generate knowledge that is relevant and useful to the community which CIP serves. The three broad programmatic aims are to: 1) Develop, implement and evaluate a sustainable infrastructure for the In Touch: Mind, Body and Spirit program including a governance structure, and an electronic data management system with outcome reporting capacity and support of field-based clinical research; 2) Implement three exploratory pilot studies to test the infrastructure and advance knowledge of the adaptive mechanisms and mental health needs of older African American men and women with differing functional status; and 3) Develop, implement and evaluate research training activities including experiential and on-site involvement for health professionals (geriatric fellows, students in medicine, nursing, occupational therapy and physical therapy) that are integrated with the pilot research efforts including how to: a) design collaborative-based clinical research, b) identify culturally relevant research questions to advance knowledge on mental health issues of the target population, c) carry out clinical research in mental health and aging in an applied setting; and d) translate evidence-based programs for the target group. The exploratory studies we plan to implement are theoretically-driven. They are designed to identify and understand the broad range of adaptive strategies and self-care practices that afford positive mental health outcomes for older African American men and women experiencing a range of age-related losses. The three exploratory studies logically and incrementally build on the other moving from descriptive to associative to predictive type research questions. These include an: 1) exploration of domains of concern with the aging process and the adaptive and cultural mechanisms for offsetting loss including symptom presentation and treatment seeking for mental health concerns among African American elders; 2) examination of differential patterns of adaptive strategy use and mental health outcomes for African American men and women with different functional status; and 3) evaluation of an intervention protocol to promote positive mental health (self-efficacy, reduced depressive symptoms) among a group of African Americans elders identified at high risk for adverse psychological well-being. Thus, initial studies will form the basis for developing and testing linguistically and culturally appropriate interventions for African American elders with different health profiles as well as the ways in which current evidence-based programs need to be translated to fit this cultural group.
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