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.
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