This application is for a Midcareer Investigator Award (K24) to support Patient-Oriented Research and Mentoring in obesity. This award will support 50% of Dr. Wee's effort for each of 5 years. Dr. Wee will devote 30% effort to mentoring postdoctoral fellows, junior faculty, and other research trainees in obesity investigation, and another 20% to expand the scope of her current research program. Dr. Wee will provide her trainees with structured mentoring and research training and assist them in initiating their own investigations and mentor them through the stages of career development. Trainees will be able to leverage the resources of Dr. Wee's current research program which includes 2 active R01 projects. The first project analyzes 3 large nationally- representative datasets to understand the interplay of race and obesity on 4 outcomes: 1) mortality;2) novel cardiovascular risk factors;3) delays in the diagnosis and control of traditional cardiovascular risk factors;and 4) healthcare expenditures. The objective of this project is to clarify whether previously observed attenuations in obesity's adverse impact on mortality and health expenditures in Africans Americans (AAs) relative to Whites can be explained by racial differences on several fronts: competing health risks;an attenuated relationship between obesity and novel cardiovascular risk factors in AAs;and disparities in diagnosis and treatment. In new research, Dr. Wee proposes a novel application of competing risk models to estimate the degree to which competing (nonobesity-related) mortality risks explain observed racial differences in BMI-mortality relationships derived from more traditional analytic methods. Dr. Wee's second R01 project is a multicenter cohort study to understand how patients value weight loss and make decisions about weight treatment particularly weight loss surgery (WLS). The goals of this project are to 1) describe the perspectives of patients in terms of their utility (value) and expectations for weight loss and their willingness to take risks to achieve weight loss;2) identify predictors that are associated with better WLS outcomes, and 3) understand the factors and barriers patients in primary care encounter in deciding whether or not to undergo WLS and other weight treatments. In new research, Dr. Wee proposes to create a blood sample data repository to explore the role genetic and other biomarkers play in patient decision-making and in predicting outcomes of WLS. This K24 award will allow the creation of a mentorship program in obesity patient-oriented research and allow Dr. Wee to expand her research portfolio in new directions that will guide clinical decision-making and public health policy related to obesity.

Public Health Relevance

This award will allow Dr. Wee to devote 50% of her time training the next generation of researchers and expanding her current research in the field of obesity. Research from her program will help us better understand how obesity affects different populations and how patients make decisions about whether to undergo weight loss treatment. This information will help guide efforts to and policy changes that might reduce current disparities in weight loss treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
1K24DK087932-01A1
Application #
8045701
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2011-09-15
Project End
2016-08-31
Budget Start
2011-09-15
Budget End
2012-08-31
Support Year
1
Fiscal Year
2011
Total Cost
$190,955
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02215
Mafi, John N; Wee, Christina C; Davis, Roger B et al. (2017) Association of Primary Care Practice Location and Ownership With the Provision of Low-Value Care in the United States. JAMA Intern Med 177:838-845
Wee, Christina C; Jones, Daniel B; Apovian, Caroline et al. (2017) Weight Loss After Bariatric Surgery: Do Clinical and Behavioral Factors Explain Racial Differences? Obes Surg 27:2873-2884
Wee, Christina C; Hamel, Mary B; Huskey, Karen W et al. (2017) The value of health and weight loss among primary care patients with moderate to severe obesity: Do quality of life factors have a larger influence than comorbidities? Obes Res Clin Pract 11:123-126
Jackson, Chandra L; Wee, Christina C; Hurtado, David A et al. (2016) Obesity trends by industry of employment in the United States, 2004 to 2011. BMC Obes 3:20
Wee, Christina C; Davis, Roger B; Jones, Dan B et al. (2016) Sex, Race, and the Quality of Life Factors Most Important to Patients' Well-Being Among Those Seeking Bariatric Surgery. Obes Surg 26:1308-16
Chacko, Sara A; Yeh, Gloria Y; Davis, Roger B et al. (2016) A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial. Complement Ther Med 28:13-21
Mafi, John N; Wee, Christina C; Davis, Roger B et al. (2016) Comparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and Physicians. Ann Intern Med 165:237-44
Halbert, Brian T; Davis, Roger B; Wee, Christina C (2016) Disproportionate longer-term opioid use among U.S. adults with mood disorders. Pain 157:2452-2457
Mafi, John N; Mejilla, Roanne; Feldman, Henry et al. (2016) Patients learning to read their doctors' notes: the importance of reminders. J Am Med Inform Assoc 23:951-5
Baer, Heather J; Wee, Christina C; DeVito, Katerina et al. (2015) Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care. Clin Trials 12:374-83

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