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A Systems-Level Intervention for Rural Adults - Administrative Supplement

The COVID-19 pandemic caused substantial disruptions to mentored research activities conducted as part of my Mentored Research Scientist Career Development Award (K01) beginning in March 2020 when the state of Michigan imposed a lockdown and the University of Michigan halted in-person research activities. The inability to conduct in-person research delayed the completion of both the pilot of Raising Our Spirits Together (ROST), our technology-assisted cognitive behavioral therapy for depression tailored for rural adults and for delivery by clergy, and my subsequent randomized controlled trial (RCT). These delays were in part related to the substantial time required to adapt from an in-person group intervention model to group-based virtual delivery as well as obtaining Institutional Review Board (IRB) approval to conduct all aspects of my pilot study and RCT virtually. Further, these changes significantly impacted the proposed recruitment methods for the RCT, leading to slower recruitment flow than anticipated in our rural target communities. Despite these delays, I have made substantial progress completing the mentored research proposed in my K01. Specifically, I successfully completed the proposed pilot, with results showing ROST was associated with statistically and clinically significant decreases in depressive symptoms and anxiety. Further, participants were highly engaged, with no one dropping out of treatment and with participants completing an average of 7.3 of the 8 ROST sessions. A manuscript reporting ROST pilot results is under review (Weaver et al., Under Review). Additionally, I have recruited 28 of the 84 participants (33.3%) required for the RCT of ROST compared to an Enhanced Control Condition. Therefore, I, along with my mentorship team, feel strongly that this administrative supplement funding additional salary support for my effort on this project, as well as applying for a no cost extension year, will allow me to successfully complete my research and training activities, and ensure the success of NIMH’s investment in this important work that offers a promising model for delivering effective, accessible, acceptable depression treatment in underserved rural communities.

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