This application for the renewal of an NIMH Mid-Career Investigator Award in Patient-Oriented Research (K24) seeks support for a family physician devoted to a career in patient-oriented research to carry out research of public health significance in the arena of community settings and mental health, and to mentor others. The application is based on careful consideration of my strengths as a clinician-investigator and the role I play as a mentor to clinician-investigators early in their career, and has the following goals: (1) to continue to attract, encourage, and mentor junior clinician-investigators to pursue high quality practice-based research related to mental disturbances in the primary health care setting;(2) to build infrastructure support that will encourage and facilitate the careers of junior clinician- investigators in disciplines such as Family Medicine and Psychiatry;(3) to contribute to the development of mixed methodology (quantitative and qualitative methods) for the design and evaluation of mental health interventions focused on primary health care settings;and, (4) to lead an interdisciplinary team that designs, implements, evaluates, and disseminates innovative interventions for depression and other psychiatric disturbances among primary care patients. The conceptual framework and activities of this K24 application rest on several principles for research and career development related to mental health interventions in primary health care and other community settings;namely: (1) the need to focus on community settings;(2) the need to involve stakeholders in development of interventions with a community-based participatory approach;(3) the use of mixed methods in research on community-based interventions;and (4) the need for an infrastructure that can sustain research in the community. The goals are consistent with NIMH Strategic Plan Strategy 3.3 which called for development of interventions "delivered by people outside of the traditional mental health systems, such as teachers and community leaders" and Strategy 4.3 "to strengthen partnerships to provide a clearer understanding of stakeholders'needs."

Public Health Relevance

Relevance Mental health consistently arises in discussions with community representatives about the most serious problems facing the community. Blending clinical and community approaches holds promise for improving the reach of interventions. Improvement of depression through increased reach of interventions and novel services delivery are key elements of the research development program represented by the K24.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
Application #
Study Section
Mental Health Services in Non-Specialty Settings (SRNS)
Program Officer
Azrin, Susan
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Johns Hopkins University
Other Health Professions
Schools of Public Health
United States
Zip Code
Hwang, Seungyoung; Jayadevappa, Ravishankar; Zee, Jarcy et al. (2015) Concordance Between Clinical Diagnosis and Medicare Claims of Depression Among Older Primary Care Patients. Am J Geriatr Psychiatry 23:726-34
Gallo, Joseph J; Morales, Knashawn H; Bogner, Hillary R et al. (2013) Long term effect of depression care management on mortality in older adults: follow-up of cluster randomized clinical trial in primary care. BMJ 346:f2570
Gonzalez, Hector M; Tarraf, Wassim; Whitfield, Keith et al. (2012) Vascular depression prevalence and epidemiology in the United States. J Psychiatr Res 46:456-61
Joo, Jin Hui; Morales, Knashawn H; de Vries, Heather F et al. (2010) Disparity in use of psychotherapy offered in primary care between older african-american and white adults: results from a practice-based depression intervention trial. J Am Geriatr Soc 58:154-60
Gallo, Joseph J; Bogner, Hillary R; Morales, Knashawn H et al. (2007) The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med 146:689-98
Barg, Frances K; Huss-Ashmore, Rebecca; Wittink, Marsha N et al. (2006) A mixed-methods approach to understanding loneliness and depression in older adults. J Gerontol B Psychol Sci Soc Sci 61:S329-39
Gallo, Joseph J; Bogner, Hillary R; Morales, Knashawn H et al. (2005) Depression, cardiovascular disease, diabetes, and two-year mortality among older, primary-care patients. Am J Geriatr Psychiatry 13:748-55