Dr. Said Ibrahim, a Professor of Medicine at Penn and Co-Director of the VA National Center for Health Equity Research and Promotion (CHERP), seeks the extension of the K24 Mid-Career Investigator Award in Patient-Oriented Research to continue this fruitful research program while dedicating significant time for mentoring the next generation of medical students, residents, clinical and post-doctoral fellows, and junior faculty trainees, particularly under-represented minorities, in his field of research. Despite nearly 25 years of national initiatives to improve the quality and equity of health and health care for vulnerable populations, the 2011 AHRQ National Healthcare and Disparities Report concluded that health care quality and access remain suboptimal, especially for minority and low-income groups. A recent economic analysis demonstrated that the direct and indirect costs of health inequalities and premature death were $1.24 trillion between 2003 and2006. Thus, health equity research directly addresses an unrelenting health care problem with overwhelming public health and economic consequences for our nation. Dr. Ibrahim leads a well-established research program on racial disparities in utilization of joint replacement in the management of end-stage osteoarthritis (OA). His work on understanding and intervening on racial disparity in access and utilization of joint replacement in the management of knee/hip OA provides a national model for advancing health disparities research from first- generation studies that detected disparities in care to second-generation studies exploring the reasons for these disparities to the first-ever third-generation intervention trials to reduce this well-documented disparity. The absence of mentors and role models is an important barrier to career advancement and is often the cause of attrition, particularly among women and minority faculty. Women and underrepresented minorities report greater difficulty finding established mentors with the protected time and effort to mentor. This has led to the call for more effective, constructive nurturing of minority faculty mentors and emphasis on promoting their careers in academic medicine. This candidate has a track record of mentoring underrepresented trainees and those who are interested in health equity research careers. Over the course of this award, the candidate will devote 45-50% effort each year to mentoring. Starting with 6 mentees in Year one, he will add 4 new mentees each subsequent year. The candidate will mentor approximately 5 students and/or residents, 5 fellows, and 8 junior faculty members in patient-oriented research in the course of this award. Therefore, the specific aims of the proposed K24 renewal application are: 1) To continue and advance a trajectory of research to understand and intervene on racial disparity in the management of end-stage knee/hip OA and access to joint replacement;2) To provide mentoring for the future generation of patient-oriented health equity investigators;and 3) To continue Dr, Ibrahim's leadership role in national and institutional efforts to diversify the U.S. health care research workforce.

Public Health Relevance

The future of patient-oriented health care research depends on continuous recruitment and successful nurturing of talented and resourceful investigators, diversifying the research workforce in the U.S., and leading the national effort to advance quality health and health care in all vulnerable populations. Numerous studies utilizing a variety of clinical and administrative databases, including Dr. Ibrahim's previous research, have documented the existence of marked racial/ethnic disparities in the utilization of joint replacement3-10-an effective treatment option for patients with end-stage knee/hip osteoarthritis (OA). These urgent objectives provide the context for this extension and will enable the candidate, Dr. Said Ibrahim, to advance his highly significant and innovative research program focused on eliminating the racial/ethnic disparities in musculoskeletal care and to provide mentoring to the next generation of medical students, residents, clinical and post-doctoral fellows and junior faculty trainees, particularly those from under- represented minorities, in patient-oriented health equity research.

National Institute of Health (NIH)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
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Panagis, James S
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University of Pennsylvania
Internal Medicine/Medicine
Schools of Medicine
United States
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Singh, Jasvinder A; Lu, Xin; Rosenthal, Gary E et al. (2014) Racial disparities in knee and hip total joint arthroplasty: an 18-year analysis of national Medicare data. Ann Rheum Dis 73:2107-15
Lane-Fall, Meghan B; Speck, Rebecca M; Ibrahim, Said A et al. (2014) Are attendings different?. Intensivists explain their handoff ideals, perceptions, and practices. Ann Am Thorac Soc 11:360-6
Singh, Jasvinder A; Lewallen, David G (2014) Time trends in the characteristics of patients undergoing primary total knee arthroplasty. Arthritis Care Res (Hoboken) 66:897-906
Allen, Kelli D; Golightly, Yvonne M; Callahan, Leigh F et al. (2014) Race and sex differences in willingness to undergo total joint replacement: the Johnston County Osteoarthritis Project. Arthritis Care Res (Hoboken) 66:1193-202
Singh, Jasvinder A; Kwoh, C Kent; Richardson, Diane et al. (2013) Sex and surgical outcomes and mortality after primary total knee arthroplasty: a risk-adjusted analysis. Arthritis Care Res (Hoboken) 65:1095-102
Halvorsen, Silje; Vollestad, Nina Kopke; Provan, Sella Arrestad et al. (2013) Cardiorespiratory fitness and cardiovascular risk in patients with ankylosing spondylitis: a cross-sectional comparative study. Arthritis Care Res (Hoboken) 65:969-76
Ibrahim, Said A; Hanusa, Barbara H; Hannon, Michael J et al. (2013) Willingness and access to joint replacement among African American patients with knee osteoarthritis: a randomized, controlled intervention. Arthritis Rheum 65:1253-61
Vina, Ernest R; Cloonan, Yona K; Ibrahim, Said A et al. (2013) Race, sex, and total knee replacement consideration: role of social support. Arthritis Care Res (Hoboken) 65:1103-11
Ibrahim, Said A; Franklin, Patricia D (2013) Race and elective joint replacement: where a disparity meets patient preference. Am J Public Health 103:583-4
Hausmann, Leslie R M; Hannon, Michael J; Kresevic, Denise M et al. (2011) Impact of perceived discrimination in healthcare on patient-provider communication. Med Care 49:626-33

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