TRAUMA IN PRIMARY CARE--INTERVENTIONS FOR POOR WOMEN

PI是创伤和创伤后应激障碍（PTSD）方面的高级研究员，她希望将她的专业知识和研究扩展到初级保健中贫困妇女干预措施的制定和评估。这份K01指导研究科学家发展申请详细介绍了一个培训和研究计划，该计划将使PI能够在精神卫生服务研究方面发展专业知识，重点是在公共医疗保健中为妇女提供与创伤有关的干预措施。该项目的目标包括：1)更好地理解和理解贫困和少数民族身份对创伤暴露、医疗保健系统经验和护理障碍的影响；2)使用深入和定性的方法，描述有创伤史的妇女与无创伤妇女的健康相关经历有何不同；3)了解创伤暴露与依恋类型之间的联系，以及这些类型与临床表现和与提供者的互动之间的关系；4)获得必要的知识，为初级保健中的受创伤妇女制定干预措施，并在这些环境中试行几种短期干预措施。长期职业目标是能够为患者和提供者制定和评估干预措施，以提高护理质量、服务满意度和适当使用服务。计划包括两位赞助者（Jeanne Miranda博士和Edward Walker医学博士）的指导，以及初级保健、定性方法、文化人类学、成人依恋和提供者-患者关系方面的心理健康干预专家的辅导。正式课程包括少数民族心理健康、定性方法、流行病学、跨文化方法和有效性研究。拟议的研究包括深入的试点研究：1)女性患者，2)提供者，以及3)观察她们之间的相互作用。这一K01对于PI深入了解贫困妇女、她们的保健环境以及她们与提供者的关系至关重要。

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.