Implementing Healthy IDEAS: Improving Translational Strategies for Late-Life Depression Treatment Through Research-Agency Partnerships

 
Principal Investigator: Nancy Morrow-Howell, PhD, PI

                                       Enola Proctor, PhD, Co-PI
Funder:
Timeframe:  02/09-10/09
Affiliation:  Center for Mental Health Services Research (CMHSR)

 

Project Staff:  Erin Leaver, BS, Project Coordinator

Project Contact:  Erin Leaver

                            (314) 935-9697

                            eleaver@wustl.edu

Project Update as of 09/22/2009
Stage: Project completed

Description

The major challenge in caring for geriatric depression lies in the implementation and delivery of evidence-based treatments.  Numerous efficacious treatments exist for late-life depression, yet many elders with depression remain untreated. This is partly due to the fact that there is limited knowledge about how to implement evidence-based interventions in real-world settings. This pilot sought to develop strategies for dissemination of interventions with demonstrated effectiveness for translation into clinical practice.

Healthy IDEAS is a nationally recognized intervention, designed for community-based case managers, and with demonstrated effectiveness in reducing depression in older adults.  The treatment developers are eager to partner with our research team to improve implementation.  The overall goal of the study was to use cutting-edge methods to capture and understand stakeholder perspectives on implementation strategies in order to embed Healthy IDEAS in case management programs in more effective ways. This two-year study, conducted by academic and community research partners, will “jump start” a subsequent R01 by accomplishing the following four aims:

Aim 1: Examine existing implementation strategies to identify dimensions that can be modified in order to better “fit’ aging case management programs. This was accomplished through document collection, consultation with treatment developers, and key informant interviews with agencies that have implemented Healthy IDEAS, or considered but did not implementation the program.  Aim 2: Quantify stakeholders’ preferences for attributes of the implementation strategy.  Web-based conjoint analysis was used to elicit stakeholders’ preferences and priorities for implementation attributes identified in Aim 1.  Aim 3: Conduct group model building with stakeholders to build an enhanced implementation strategy for use with case management programs serving older adults. The goal was to develop an enhanced implementation strategy that is acceptable and feasible for agencies serving older adults. This strategy will reflect stakeholders’ preferences regarding efficiency and cost, and thus enhance sustainability of Healthy IDEAS.  Aim 4:  Compare stakeholder perspectives of the enhanced implementation strategy versus the usual strategy in terms of acceptability and feasibility and readiness to adopt. Administrators, supervisors, and case managers who are considering the implementation of Healthy Ideas will comparatively evaluate the enhanced strategy to the usual strategy and we will have preliminary data regarding the extent to which the enhanced strategy is more acceptable and feasible.

This project accelerated the movement of scientific findings into clinical practice.  Acceleration of scientific findings benefits the scientific community, service agencies and professionals, service recipients, and taxpayers investing in science, all of who pay a price when evidence-based practices languish on the shelf for 15-20 years before they are incorporated into usual care.  Ultimately, this project improved depression care for older adults, thus alleviating a condition known to cause great suffering and disability.