Breaking Ground, Breaking Through: The Strategic Plan for Mood Disorders Research called for interdisciplinary training to increase capacity for community-based research employing different theoretical approaches that are needed to understand what treatments or services are effective for whom, under what circumstances, and why. The task of blending theoretical approaches is particularly relevant to designing services given the heterogeneity in concepts of illness and treatment, preferences for care, and expectations about treatment that occur in primary care settings among providers, patients, families, and communities. At the same time, the NIH Director's Panel on Clinical Research Report pointed out that a shortage of physician-scientists committed to a career in patient-oriented research has serious consequences for the health of all Americans. Accordingly, this application for an NIMH Midcareer 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 and to mentor others in primary health care and mental health. 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; namely: (1) the need to involve the patients and providers in development of interventions; (2) the use of mixed models for design and evaluation of interventions; and (3) the need for infrastructure development for sustained research on interventions in """"""""real world"""""""" settings.
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