Whose Depression Are We Measuring?: Considering the role of place on Black women’s depression outcomes

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PROJECT SUMMARY/ABSTRACT This proposed work will examine how place-based characteristics and other social determinants of health contribute to racial disparities in the experience and expression of depression, considering obesity as a mediator and moderator of that relationship. This and analyzing narratives from semi-structured interviews. This supplemental work will employ qualitative methods and new quantitative data resources regarding social determinants of health to address two specific aims. In the first aim, multi-level structural equation modeling (SEM) will be used to examine the longitudinal relationships among place-based social determinants of health, obesity, and the experience and expression of depression among Black women. Moreover, analyses will allow measurement of cross-lagged effects of depression symptoms (measured by PHQ-9 and BMI) and the effect that moving locations has on health outcomes. In Aim 2, using a grounded theory approach, 20 semi- structured interviews with a subsample of Aim I’s patients will be conducted and analyzed to capture how lived experiences of Black women affect experience of and expression of depression. Semi-structured interviews will cover topics including 1.) stress exposure over the life course, 2.) current (self-reported) mental and physical health status, 4.) decision-making about food choices, 3.) interactions with the health system, including mental health professionals, 4.) coping behaviors, and 5.) values and beliefs about health. Wilson will use her training in sociology and mixed methodologies to lead all research activities. Additionally, Wilson will undergo training and mentoring to: 1.) develop Geographic Information Systems (GIS) mapping and spatial analysis skills, 2.) increase knowledge and familiarity of the research tools available from VDW and MHRN, and 3.) enhance grant writing skills including identifying appropriate NIMH grants at her career stage. Dr. Wilson will disseminate findings from the proposed work at two conferences and submit a manuscript for publication during the supplemental period. Dr. Wilson’s overall career development will be enhanced by the increased proficiency and knowledge of tools for using electronic health records and census-based databases, mentorship, and research activities. Moreover, as a Black/African-American woman, Dr. Wilson is part of an underrepresented group, both in the pool of applicants and awardees of NIMH investigator-initiated funding. The proposed work will strengthen Dr. Wilson’s profile as a candidate on investigator-initiated proposals submitted to NIMH R01 and other funding announcements.