The applicant is a family scientist who plans to have a research career developing interventions that address social and behavioral risk factors for adverse outcomes in chronic obstructive pulmonary disease (COPD). The proposed career development plan will provide mentoring and a structured didactic curriculum in public health that culminates in the applicant earning a Master's in Public Health. Advanced training in public health is essential to expanding the range of social factors that the applicant can assess and ultimately address in clinical interventions. Training goals include developing mastery in assessing aspects of the social environment beyond the family, extending the applicant's skills in methods of data analysis, and understanding psychosocial implications of having an identified genetic subtype of COPD.
The aim of the proposed research is to test key paths in a model linking the social environment, psychological distress, and clinical outcomes among people with COPD. The applicant will comprehensively measure important aspects of the social environment, psychological distress, and clinical outcomes through self-report, clinical interview, and laboratory-based assessments. Data will be collected at three time points, each 12 months apart. Three hypotheses will be tested: 1) unsupportive family relationships, low social support, and lack of community resources will predict an increase in psychological distress;2) the characteristics of the social environment described in Hypothesis 1 will predict deterioration in clinical outcomes (e.g., greater reduction in exercise capacity);and 3) high psychological distress will predict deterioration in clinical outcomes and mediate the effect of the social environment on clinical outcomes. The proposed research has direct relevance to public health. As the fourth leading cause of death in the United States, COPD is a major public health problem. The proposed research will provide data that are vitally important to the development of psychosocial interventions for people with COPD. The most comprehensive interventions can be developed after research establishes which aspects of the social environment are most crucial in affecting psychological distress and clinical outcomes in COPD. The training and research described in this proposal will provide the applicant with the skills to become an independent researcher focusing on the development of novel psychosocial interventions to improve clinical outcomes for people with COPD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL091049-05
Application #
8294997
Study Section
Special Emphasis Panel (ZHL1-CSR-R (M1))
Program Officer
Tigno, Xenia
Project Start
2008-07-11
Project End
2014-06-30
Budget Start
2012-07-01
Budget End
2014-06-30
Support Year
5
Fiscal Year
2012
Total Cost
$134,993
Indirect Cost
$9,755
Name
National Jewish Health
Department
Type
DUNS #
076443019
City
Denver
State
CO
Country
United States
Zip Code
80206
Hoth, Karin F; Wamboldt, Frederick S; Ford, Dee W et al. (2015) The social environment and illness uncertainty in chronic obstructive pulmonary disease. Int J Behav Med 22:223-32
Holm, Kristen E; Plaufcan, Melissa R; Ford, Dee W et al. (2014) The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status. J Behav Med 37:654-63
Holm, Kristen E; Wamboldt, Frederick S; Ford, Dee W et al. (2013) The prospective association of perceived criticism with dyspnea in chronic lung disease. J Psychosom Res 74:450-3
Hoth, Karin F; Wamboldt, Frederick S; Strand, Matthew et al. (2013) Prospective impact of illness uncertainty on outcomes in chronic lung disease. Health Psychol 32:1170-4
Holm, Kristen E; Borson, Soo; Sandhaus, Robert A et al. (2013) Differences in adjustment between individuals with alpha-1 antitrypsin deficiency (AATD)-associated COPD and non-AATD COPD. COPD 10:226-34
Plaufcan, Melissa R; Wamboldt, Frederick S; Holm, Kristen E (2012) Behavioral and characterological self-blame in chronic obstructive pulmonary disease. J Psychosom Res 72:78-83
Hoth, Karin F; Wamboldt, Frederick S; Bowler, Russell et al. (2011) Attributions about cause of illness in chronic obstructive pulmonary disease. J Psychosom Res 70:465-72
Holm, Kristen E; LaChance, Heather R; Bowler, Russell P et al. (2010) Family factors are associated with psychological distress and smoking status in chronic obstructive pulmonary disease. Gen Hosp Psychiatry 32:492-8
Holm, Kristen E; Bowler, Russell P; Make, Barry J et al. (2009) Family relationship quality is associated with psychological distress, dyspnea, and quality of life in COPD. COPD 6:359-68