Nolan Zane - US grants

This application requests five years of funding to continue leading-edge research of the National Research Center on Asian American Mental Health (NRCAAMH). The long-term objectives are to make significant theoretical and applied contributions to increase access and better quality of mental health care for Asian Americans. Years of research have demonstrated that Asian Americans have extremely low rates of utilization of mental health services, despite having substantial mental health needs. The specific aims of the research program are to advance knowledge on quality of care for Asian Americans in four aspects of utilization and effectiveness of services: (1) investigate the pathways to mental health care among Filipino Americans, using a longitudinal, prospective design; (2) examine the role of ethnic specific services in facilitating access to care for the Asian American population in different mental health systems; (3) experimentally test whether specific intervention deemed to be culturally consistent with clients are effective compared to standard treatment procedures in psychotherapy; (4) identify and test culturally-based care compared with standard care for Asian American trauma patients. In order to accomplish these aims, NRCAAMH will utilize innovative research designs (e.g., longitudinal, prospective methods) and actual experimental intervention projects that take Asian American mental health research to a new level of understanding of how to devise a culturally effective care system. These strategies that will provide insights and new knowledge into quality of care for Asian Americans. Four projects will be conducted in a multi-site program of research. The projects are carried out under the direction of NRCAAMH which has an organizational structure that promotes collaboration among investigators such that the choice of projects as well as the systematic evaluation of projects are performed by this team of researchers. The organizational components include the Administrative Core, Statistical and Methodology Core, four Research Projects, Executive Committee, National Advisory Board, and community-based agencies.

Administrative Core Personnel and Responsibilities The center's headquarters are located at the University of California, Davis. Administration Core staff of the center include the center Director, Core Directors, Statistician, Computer Specialist, Data Manager, and other research assistants. Although there will be some overlap in roles, the following are the responsibilities of the various staff of the Administrative Core: The center Director is responsible for the center's daily operations and for the direction of the research;the Statistician facilitates the design and analysis of data;the Computer Specialist develops and maintains the Internet-accessible Information Server computer system;the Data Manager and research assistants assist the Director and other administration staff with office activities, grant and manuscript preparations, data management, and data collection.

[unreadable] DESCRIPTION (provided by applicant): 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 [unreadable] 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. [unreadable] [unreadable] [unreadable]

Address; American; Asian Americans; Asians; base; Clinical effectiveness; Cognitive Therapy; cultural values; design; effective therapy; Effectiveness; effectiveness research; effectiveness trial; emotional disclosure; European; Expectancy; expectation; Face; improved; Intervention; Major Depressive Disorder; Medical; Mental Depression; Modification; Patients; Pharmacotherapy; programs; psychologic; Psychotherapy; Randomized; Relative (related person); Research; Self Disclosure; treatment as usual; treatment effect; Treatment Effectiveness

Acculturation; Adherence (attribute); Adult; Adverse effects; Antidepressive Agents; Applications Grants; Asians; Attention; Attitude; base; Belief; Caring; caucasian American; Client; Clinic; compare effectiveness; Compliance behavior; Diagnosis; Dropout; Effectiveness of Interventions; Endogenous depression; Ethnography; Face; Family; Family member; Flecks; Focus Groups; Goals; group intervention; Group Interviews; Health; Health Services; Health system; Healthcare; Home environment; improved; informant; innovation; Intervention; Knowledge; Mainstreaming (Education); Measures; medication compliance; Mental Depression; Mental Health; Outcome; Outpatients; Patients; Pharmaceutical Preparations; Phase; Population; premature; primary care setting; programs; Psychiatrist; psychoeducation; psychoeducational; Psychologist; psychosocial; Randomized Controlled Trials; Research; Research Personnel; response; satisfaction; Shame; sociologist; southeast Asian; Testing; Training

health science research analysis /evaluation; statistics /biometry

Accounting; Address; Adopted; American; Asian Americans; Asians; Au element; Awareness; Awarenesses; Class; Client; Competence; Data; Distal; Educational workshop; Effectiveness; Ethnic Origin; Ethnic and Racial Minorities; Ethnicity; Ethnicity aspects; Evaluation; Evidence based practice; Focus Groups; Funding; Gold; Health Care Professional; Health Professional; Health profession; Healthcare professional; Healthcare worker; Investigators; Knowledge; Link; Measures; Mediating; Mental Health; Mental Health Services; Mental Hygiene; Mental Hygiene Services; Minority Groups; NIH RFA; Nature; Numbers; Outcome; Patient Self-Report; Patients; Performance; Persons; Programs (PT); Programs [Publication Type]; Psychological Health; QOC; Quality of Care; Request for Applications; Research; Research Design; Research Personnel; Researchers; Sampling; Score; Self-Report; Services; Solid; Standards; Standards of Weights and Measures; Students; Study Type; Surgeon; Testing; Therapeutic; Training; Treatment Factor; Treatment outcome; Work; Workshop; base; ethnic minority; ethnic minority population; experience; improved; insight; oriental; programs; prospective; racial and ethnic; racial/ethnic; skills; study design