Randall S. Stafford, MD, PhD is a clinical epidemiologist, obesity researcher, and practicing primary care internist. This K24 renewal proposal capitalizes on Dr. Stafford's clinical research expertise, ongoing research program, and mentoring experience. With training in Internal Medicine (MD UCSF, Residency MGH) and Epidemiology (PhD UC Berkeley, post-doc CDC), Dr. Stafford is currently an Associate Professor of Medicine at Stanford University. He directs the Stanford Program on Prevention Outcomes and Practices (PPOP) and is clinically active in Preventive Cardiology and Primary Care Internal Medicine. Stanford University provides an exceptional setting for patient-oriented research training. Dr. Stafford's mentoring plan leverages existing training resources, particularly those of Stanford's CTSA.
The Specific Aims of this renewal award are to: 1) Leverage Dr. Stafford's successful POR agenda, as well as the outstanding environment of Stanford University to enlarge an innovative and dynamic setting for POR training;2) Build on Dr. Stafford's success as a K24 mentor and his continued development of new research and mentoring skills to apply a more systematic approach to mentoring that supplements the traditional apprenticeship model;3)Through salary support and the increased availability of protected mentoring time, enhance Dr. Stafford's capacity to provide a greater depth of mentoring to a larger number of mentees;4) Enrich Dr. Stafford's research career through skill growth, career re-focusing, and an impact-oriented emphasis. Clinical research, particularly patient-oriented research (POR), is critical to the translation of scientific knowledge into population health benefits. The process by which new medical practices and knowledge are disseminated, however, often fails to serve patients'best interests. Some new practices are readily adopted without adequate assessment while others with strong evidence-based support are adopted slowly and inconsistently. National investment in biomedical science is jeopardized if we fail to guide the translation of scientific evidence into practice. Given the importance of translating research into practice, it is ironic how difficult it is for clinically trained physicins to pursue careers in POR that emphasize population health. Adequate mentoring has been identified as a critical, but often missing, resource in the clinical research career development pathway. Dr. Stafford is intent on supporting the career needs of mentees to ensure that they can pursue long-term careers in population science with idealism and purpose. The research opportunities available from Dr. Stafford's own POR portfolio provide an excellent milieu for population science and POR training. Dr. Stafford's research aims to understand the forces influencing physician and patient behavior, with a focus on intervening to improve health outcomes through prevention. Dr. Stafford's objective is to further develop the science of health care innovation as a vehicle for designing prevention interventions to facilitate evidence-based practices by patients, their care providers, and health care systems. This research agenda is reinforced and stimulated by an array of clinical and teaching/mentoring activities. Mentoring a wide variety of trainees and junior faculty members not only provides a multidisciplinary intellectual community that brings to life the vital importance of these issues, but also creates successful scientists and future leaders.

Public Health Relevance

Recent health care reform emphasizes that the return on the national investment in scientific research is suboptimal. Scientific knowledge is often not translated into widely adopted and clinically efficient applications that can improve population health. This project leverages Dr. Stafford's extensive patient- oriented research experience and an innovative training plan that focuses on mentee career needs to train the next generation of translational scientists.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
Application #
Study Section
Special Emphasis Panel (ZHL1-CSR-X (F1))
Program Officer
Czajkowski, Susan
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Stanford University
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Hurley, Michael P; Stafford, Randall S; Lane, Alfred T (2014) Characterizing the relationship between free drug samples and prescription patterns for acne vulgaris and rosacea. JAMA Dermatol 150:487-93
Turner, Lydia W; Nartey, David; Stafford, Randall S et al. (2014) Ambulatory treatment of type 2 diabetes in the U.S., 1997-2012. Diabetes Care 37:985-92
Banerjee, Dipanjan; Chung, Sukyung; Wong, Eric C et al. (2012) Underdiagnosis of hypertension using electronic health records. Am J Hypertens 25:97-102
Tsai, Sandra A; Stefanick, Marcia L; Stafford, Randall S (2011) Trends in menopausal hormone therapy use of US office-based physicians, 2000-2009. Menopause 18:385-92
Logan, Aaron C; Yank, Veronica; Stafford, Randall S (2011) Off-label use of recombinant factor VIIa in U.S. hospitals: analysis of hospital records. Ann Intern Med 154:516-22
Yank, Veronica; Tuohy, C Vaughan; Logan, Aaron C et al. (2011) Systematic review: benefits and harms of in-hospital use of recombinant factor VIIa for off-label indications. Ann Intern Med 154:529-40
Alexander, G C; Gallagher, S A; Mascola, A et al. (2011) Increasing off-label use of antipsychotic medications in the United States, 1995-2008. Pharmacoepidemiol Drug Saf 20:177-84
Romano, Max J; Stafford, Randall S (2011) Electronic health records and clinical decision support systems: impact on national ambulatory care quality. Arch Intern Med 171:897-903
Alexander, G Caleb; O'Connor, Alec B; Stafford, Randall S (2011) Enhancing prescription drug innovation and adoption. Ann Intern Med 154:833-7, W-301
Hersh, Adam L; Stafford, Randall S (2011) Antiviral prescribing by office-based physicians during the 2009 H1N1 pandemic. Ann Intern Med 154:74-6

Showing the most recent 10 out of 18 publications