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Principal Investigator: MARGARITA ALEGRIA
Organization: MASSACHUSETTS GENERAL HOSPITAL
Fiscal Year: 2024
Award: $941,888
Funding agency: National Institute on Aging
PROJECT SUMMARY
Although minority elders represent the fastest growing segment of an aging US population, they have less
access to mental health care and prevention of disability, lagging well behind non-Latino whites, and suffering
significant disparities. Research suggests that a contributing factor may be an insufficient supply of
professional providers and the inability of evidence based treatments to reach and be acceptable to minority
elders. We have obtained promising results from a novel model of disability prevention, the Positive Minds
Strong Bodies (E-PMSB) intervention, embedded in the client’s neighborhood and culture to improve access,
quality of mental health outcomes and reduce disability. The proposed renewal tests whether an enhanced
PMSB intervention is acceptable in community-based organizations and community clinics, and allows
effectiveness to be strengthened through added maintenance components. We identified areas to strengthen
the intervention, to facilitate easier adoption at the organizational level, to increase mental health symptom
reduction beyond 6 months, and augment dosage of the exercise component. In Aim 2 we will assess
implementation readiness of the E-PMSB, to ensure that its package of interventions is feasible and can be
easily adopted, with reduced barriers to its sustainability. Informed by the Consolidated Framework for
Implementation Research (CFIR), we will assess facilitators and barriers to implementation. A learning
community consisting of community-based organizations (CBOs), clinical sites and academic partners will
share elements that have contributed to initial success and can strengthen the collaboration. For Aim 3, we will
create and evaluate a toolkit to disseminate the program, with a focus on developing cultural and age
appropriate evidence-based messaging, packaging, and an overview of the implementation process and
financing. This dynamic toolkit will be designed for use by community organizations, community health workers
(CHWs), exercise trainers, and program participants, targeting strategies for capacity building as well as
implementation. Drawing on the feedback from participating sites, we envision refining materials in the last 6
months of the project to have a lasting product that can be disseminated, and that not only facilitates positive
intervention outcomes but additionally support organizations to optimize implementation success, fidelity, and
sustainability.
Terms: <65 and older><65 or older><65 years of age and older><65 years of age or more><65 years of age or older><65+ years><65+ years old><> 65 years><Acceleration><Address><Adopted><Adoption><Affective Disorders><Age><Aged 65 and Over><Aging><Area><Assess implementation><Caring><Client><Clinic><Clinical><Clinical Services><Collaborations><Communities><Community Health Aides><Consolidated Framework for Implementation Research><Consolidated Framework for Implementation Science><Consolidated Framework for Implementing Change><Disability prevention><Disparities><Disparity><Dissemination and Implementation><Effectiveness><Effectiveness of Interventions><Elderly><Elements><Enrollment><Environment><Espanol><Ethnic Origin><Ethnicity><Evidence based treatment><Exercise><Feedback><Florida><Funding><Geographic Area><Geographic Locations><Geographic Region><Geographical Location><Grant><Health Care Professional><Health Professional><Healthcare professional><Implementation assessment><Implementation readiness><Improve Access><Individual><Individuals from minority><Individuals of minority><Intervention><Intervention Strategies><Language><Limited English Proficiency><Linguistic><Linguistics><Low-resource area><Low-resource community><Low-resource environment><Low-resource region><Low-resource setting><Maintenance><Massachusetts><Mental Depression><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Mental disability><Mental disorders><Mental health disorders><Mind><Minority><Minority Groups><Minority People><Minority Population><Minority individual><Modeling><Mood Disorders><NIMH><National Institute of Mental Health><Neighborhoods><New Agents><New York><Non-Hispanic><Nonhispanic><Not Hispanic or Latino><Older Population><Outcome><Participant><Patients><Persons><Phase><Physical activity><Population><Preventative intervention><Preventing disabilities><Provider><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Puerto Rico><Race><Races><Recurrence><Recurrent><Reporting><Research><Research Resources><Resource-constrained area><Resource-constrained community><Resource-constrained environment><Resource-constrained region><Resource-constrained setting><Resource-limited area><Resource-limited community><Resource-limited environment><Resource-limited region><Resource-limited setting><Resource-poor area><Resource-poor community><Resource-poor environment><Resource-poor region><Resource-poor setting><Resources><Risk><Services><Severities><Site><Source><Spanish><Testing><Therapeutic><Training><Work><above age 65><advanced age><after age 65><age 65 and greater><age 65 and older><age 65 or older><age > 65><age of 65 years onward><aged 65 and greater><aged 65+><aged ≥65><ages><alleviate symptom><ameliorating symptom><barriers to implementation><clinical research site><clinical site><community based organizations><community building><community clinic><community health worker><community organizations><community setting><cultural competence><culturally competent><decrease symptom><depression><design><designing><disability><disability risk><dosage><effective intervention><effectiveness testing><emotional distress><enroll><ethnic minority group><ethnic minority individual><ethnic minority people><ethnic minority population><evaluate implementation><evaluation of implementation><evidence base><feeling distress><feeling upset><fewer symptoms><frailty><geographic site><geriatric><help seeking><help-seeking behavior><human old age (65+)><implementation barriers><implementation challenges><implementation evaluation><implementation process><improved><innovate><innovation><innovative><interest><intervention for prevention><intervention participants><interventional strategy><learning community><mental health care><mental healthcare><mental illness><mood symptom><novel><old age><older adult><older adulthood><older groups><older individuals><older person><over 65 years><physical disability><physically disabled><physically handicapped><prevention intervention><prevention service><preventional intervention strategy><preventive intervention><programs><psychiatric illness><psychoeducation><psychological disorder><racial><racial background><racial minority group><racial minority individual><racial minority people><racial minority population><racial origin><reduce symptoms><relieves symptoms><self reliance><senior citizen><social stigma><stigma><substance use><substance using><success><symptom alleviation><symptom reduction><symptom relief><treatment research><uptake><≥65 years>