Research Network Development Core (pages 329-374)

University Of Pittsburgh At Pittsburgh, Pittsburgh PA

Investigators

Linked publications & trials

Abstract

Significant barriers exist in the recognition and successful treatment of mood disorders in older primary care patients. The Research Network Development Core (RNDC) proposes to develop a sustainable research infrastructure to enhance the capacity of two primary care organizations to identify, treat, retain, and study older black and white primary care patients with mood disorders. This proposal is the product of a partnership formed over the past several years between Coordinated Care Network and Community Medicine, Inc. (two non-academic community-based primary care networks in Western Pennsylvania), the Mental Health Association of Allegheny County, the University of Pittsburgh Center for Minority Health, and the ACSIR/LLMD. Most older persons who live with mood disorders are cared for by their primary care providers (PCPs). Primary care patients who are both old and black constitute the group least likely to be diagnosed by their PCPs, to be engaged in treatment, and to respond to treatment. Similarly, older black patients appear to be less likely to be recruited and retained in research studies of mood disorders. The focus of this Core is on studying how to reduce these disparities by improving identification, enrollment, and retention of older black primary care patients with mood disorders. Ultimately this work will result in better identification, treatment engagement, process of care, and outcome of both black and white older primary care patients with mood disorders. Available data are insufficient to completely understand and eliminate the factors underlying health disparities in the treatment of late-life mood disorders, but suggest that factors at the patient, provider, and practice/system levels are relevant. Therefore, we propose to undertake infrastructure development activities to study and reduce these disparities by developing culturally-sensitive and ethically-sound strategies to enhance recognition of mood disorders, acceptance of, and engagement in, treatment and research. The RNDC is linked thematically and methodologically to the ACISR/LLMD Operations Core (e.g., Information Dissemination, Research Training, and Research Ethics Subunits), Principal Research Core (e.g., Projects 6, 7, and 8, dealing with patient-level, organizational, and economic barriers to effective treatment in the community), and to the Research Methods Core (e.g., the Intervention Portability, Effectiveness, and Dissemination Unit and the Research Design and Biostatistics Unit). These linkages will help to ensure the success of the RNDC and increase return from these cores.