This K01 award will launch Dr. Kerry Kinney’s independent research career focused on reducing disparities in the diagnosis and treatment of generalized anxiety disorder (GAD). GAD is the most common anxiety disorder in primary care settings, where the rate of GAD misdiagnosis is estimated at 67-71%. Misdiagnosis can delay treatment, exacerbate chronicity, and increase personal and societal costs. The proposed K01 research leverages large-scale, epidemiologic and electronic health record (EHR) datasets to evaluate two potential contributors to GAD misdiagnosis: 1) longitudinal measurement non-invariance, or indications that GAD’s diagnostic criteria fail to capture the same construct across over time or across various levels of economic hardship, and 2) lack of patient-centered care, which is characterized by collaborative decision-making and respecting patients’ values and context. To accomplish Aim 1, Dr. Kinney will assess for the presence of measurement non-invariance and differential item functioning in GAD symptom criteria over time and whether longitudinal measurement invariance is moderated by economic hardship in epidemiologic datasets. To accomplish Aim 2, Dr. Kinney will employ natural language processing in EHR data to identify language indicative of non-patient-centered care in primary care notes. She will assess how non-patient-centered care relates to individual patient characteristics and GAD diagnosis. Dr. Kinney proposes to build upon her strong foundational training by targeting career development in: 1) advanced quantitative modeling to enhance theoretical models of GAD; 2) the technical biomedical informatics and textual analysis skills necessary to harness EHR data for health disparities research; and 3) grant-writing skills to obtain independent extramural funding. Dr. Kinney has assembled a highly qualified, interdisciplinary team of mentors, collaborators, and consultants to support her in achieving these training aims. Collectively, the proposed mentor (Dr. Matthew Morris), collaborators (Drs. Glenn Gobbel, Mohammed Al-Garadi, David Cole, and Jacquelyn Pennings), and consultants (Drs. Matthew Diemer and Siddharth Pratap) provide the optimal combination of expertise to facilitate the successful completion of the proposed research and training plan and launch Dr. Kinney’s independent research career. The research and training aims will occur in the exceptional, multidisciplinary, resource-rich environment at Vanderbilt University Medical Center. This K01 award will support Dr. Kinney in establishing an independent research program that aims to advance the field’s understanding of GAD and elucidate the mechanisms underlying missed or delayed opportunities to diagnose and treat GAD.