TRAUMA IN PRIMARY CARE--INTERVENTIONS FOR POOR WOMEN

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The PI is a senior investigator in trauma and posttraumatic stress disorder (PTSD) who wishes to extend her expertise and her research to the development and evaluation of interventions for poor women in primary care. This K01 Mentored Research Scientist Development application details a training and research program that will allow the PI to develop expertise in mental health services research focused on trauma-related interventions for women in public medical care. Goals of the project include: 1) To better understand and appreciate the impact of poverty and minority status on trauma exposure, experiences in the health care system, and barriers to care; 2) To delineate how health- related experiences of women with trauma histories differ from those of women without trauma, using in-depth and qualitative methodologies; 3) To understand links between trauma exposure and attachment style, and how these styles are related to clinical presentation and interactions with providers; and 4) To gain the knowledge necessary to develop interventions for traumatized women in primary care, and to pilot several short interventions in these settings. The long-term career goal is to be able to develop and evaluate interventions for patients and providers that increase quality of care, satisfaction with services, and appropriate use of services. Plans include mentoring from two sponsors, Jeanne Miranda, PhD, and Edward Walker, MD, and tutorials from experts in mental health interventions in primary care, qualitative methods, cultural anthropology, adult attachment, and provider-patient relationships. Formal coursework includes courses in minority mental health, qualitative methodologies, epidemiology, cross-cultural methods, and effectiveness research. Proposed research includes in-depth pilot studies of 1) women patients, 2) providers, and 3) observations of their interactions. This K01 is crucial for the PI's development of in-depth knowledge about poor women, their health care settings, and their relationships with providers.