This application for a Mid-Career Investigator Award in Patient-Oriented Research (K-24) requests support for the candidate to increase mentoring of beginning clinical investigators and enhance her patient-oriented research. This research focuses on interventions for financially-disadvantage (FD) mothers because these women are at high risk for mood and anxiety disorders, in particular, disorders related to interpersonal violence, such as posttraumatic stress disorder (PTSD) and major depression. Despite the distress and marked impairment associated with PTSD and major depression, few interventions have been systematically tested that include FD women with these disorders, because factors, such as instrumental barriers (e.g., child care, transport), pregnancy, or breastfeeding have excluded these women from participation in clinical trials or access to treatment. As a researcher with an extensive background in the mental health of women, in particular trauma, PTSD, and major depression, the candidate proposes to continue and expand her patient-oriented research on this understudied, underserved, and vulnerable group of women. The chief aim of this proposal is to use time liberated by the Mid-Career Investigator Award in Patient-Oriented Research to increase the candidate's knowledge of several areas relevant to her future research and to develop, evaluate and disseminate new information on interventions for FD mothers. To this end, the career development plan increases the candidate's experience, knowledge, and skills in the following areas: 1) Child and maternal-infant interaction assessment training and parent intervention training. 2) Statistics, intervention study design and methodology, and cost issues. The career development plan also proposes to 1) expand the candidate's mentoring of beginning investigators with the goal of attracting them to a career in patient-oriented research, and 2) increase awareness of mental health disorders and interpersonal violence in the lives of FD women by educating professionals, legislators, and the public. This application's research plan focuses on two ongoing R-21 studies of interventions with FD women, ongoing research, pending research, and proposed intervention research with FD mothers. In summary, this award would provide critical support for the candidate's career development, mentoring, and ongoing and new patient-oriented research on a high-risk and understudied group of women.
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