ABSTRACT. The UW ALACRITY Center purpose is to address critical problems in the implementation of evidence-based psychosocial interventions (EBPIs) for underserved communities as they are delivered in primary care medicine settings. Per a recent IOM report on psychosocial intervention standards, access to EBPIs is hampered by (1) poor clinician training, (2) intervention design complexity, and (3) insufficient support to sustain quality of care. We will attempt to solve these problems by creating a team of researchers from human centered design (Drs. Fogarty, Gonzalez, Munson, Popovic), education (Raue, Popovic), implementation science (Drs. Bennett and Lyon), psychosocial interventions (Drs. Aisenberg, Arean, Kaysen, Raue), health services research (Dr. Fortney, Ratzliff and Unutzer) and research methods (Dr. Atkins and Hoeft). The Center represents a unique partnership between the School of Medicine’s Departments of Psychiatry/Behavioral Sciences and Family Medicine, the Department of Computer Science and Engineering, the Department of Communications, and the School of Social Work. The Center also bridges UW’s many resources: CoMotion (UW’s center for health technology innovation), the Institute for Translational Health Sciences (the UW CTSA), the AIMS Center (UW implementation and training center for collaborative care), and the WWAMI-region Practice Research Network (WPRN, a collaborative group of primary care practices through the states of Washington, Wyoming, Alaska, Montana and Idaho to facilitate innovative community- based research). The Administrative Core will serve as the communication hub between center cores, our two advisory boards, and will oversee the solicitation and selection of R03 level proof of concept studies. The Methods Core (MC) will provide research infrastructure to the projects. Each project will use our Discover, Design, Build and Test framework to address clinician capacity, intervention usability and intervention sustainability. The MC will also compile data from these projects to create a Typology of EBPI Targets and a Matrix of EBPI Modifications that will be shared with other researchers within and outside of UW through our online research community. Research projects will collect a common core of outcomes to determine the impact of modifying EBPI targets on clinicians’ quality delivery of care and patient-reported outcomes. The first R34 project proposes to improve clinician EPBI capacity by designing and building an Intelligent Tutor System based on adaptive training. The second R34 project will partner with the WPRN to simplify problem-solving therapy (PST), using user-centered design principles. The third R34 project will partner with the Washington Behavioral Health Integration Program (BHIP) to develop an electronic health record-supported behavioral health module and registry to support sustained clinician skill in delivering PST in primary care. All three projects, and future R03s, will test the effects modification targets of implementation outcomes (time to training, clinician skill drift), system usability, EBPI system burden, system acceptability, and patient-reported outcomes.

PROJECT NARRATIVE Psychosocial interventions are the preferred mode of treatment for people seeking treatment for depression , particularly among underserved communities, such as racial and ethnic minorities and those living in low-income communities, yet, very few people gain access to evidence-based psychosocial treatments because too few clinicians are trained to deliver them, they tend to be too complex to delivered in settings like primary care medicine, and there are too few supports to clinicians to deliver these interventions to high quality. The UW ALACRITY Center will attempt to address these issues by creating a novel framework informed by experts in human centered design technology, education, and implementation science. This team will develop and test three new solutions for addressing problems in the clinician capacity, intervention usability and sustainability of psychosocial interventions delivered in primary care medicine, and will support 8 new, proof of concept projects over the 4 year timeline.