This application requests five years of support for a Mentored Research Scientist Development Award (K01) for a new minority investigator. The objectives of the planned training program are two-fold. The first objective is to provide the minority candidate with contemporary training in the areas of statistics, research methodology, research ethics, the pathophysiology of headache disorders, cross-cultural psychology, and health disparities. Formal coursework in these areas will facilitate the successful conduct of the planned study and prepare the candidate for future research endeavors throughout her career. The second objective is to examine how race and psychiatric co-morbid conditions are related to headache severity, quality of life, treatment adherence, and ability to respond favorably to treatments in people with episodic migraines, chronic migraines, episodic tension-type headaches, chronic tension-type headaches, substance abuse headaches, or cluster headaches. Using a quasi-experimental prospective research design, 400 patients presenting at outpatient medical centers in four urban areas of Ohio (Cincinnati, Cleveland, Columbus, and Toledo) will complete self-administered assessments, telephone-based interviews, and daily headache diaries that elicit data on headache severity, quality of life, social support, treatment self-efficacy, locus of control, treatment adherence, and treatment outcome. Guided by Social Cognitive Theory (SCT; Bandura, 1986), the planned study will employ structural equation modeling path analysis to determine whether SCT constructs, such as social support, health-related locus of control, and treatment self-efficacy, mediate associations between race and the presence of a co-morbid psychiatric disorder and key outcome measures, such as quality of life and treatment outcome. If successful, the candidate will obtain extramural funding prior to the completion of the training program that will enable her to conceptualize, implement, and evaluate a culturally-contextualized intervention to reduce headache pain and improve the life quality of people who experience severe headache characteristics.
