Monika M. Safford, MD is Associate Professor of Medicine at the University of Alabama at Birmingham (UAB), where she has built a successful research program in observational and implementation research. This proposed award will permit her to consolidate her effort to continue her mentoring activities while also building her research program in two main areas: 1) in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a community-dwelling prospective cohort of 30,239 Black and White individuals;and 2) the Encourage program, which consists of two large extramurally funded group-randomized implementation trials of peer support interventions to improve cardiometabolic parameters in individuals with diabetes. Her main scientific career goals are to better understand underlying reasons for regional and racial disparities in acute CHD outcomes, and to test interventions designed to improve them, with a focus on underserved populations and complex patients, especially those with diabetes. Since focusing her career on cardiometabolic research 13 years ago, she has maintained uninterrupted federal funding totaling over $17 million as Principal Investigator (PI) and has published 159 peer-reviewed reports. Over this time, she has also fostered the academic research careers of 18 clinical fellows and junior clinical faculty, many of whom now have successful independent research careers in patient-oriented research. Her position as Co-PI of the UAB Health Services Research (HSR) Fellowship, which includes 18 Fellows at any time, assures a steady supply of potential mentees. Her Mentoring Aims are to continue to build her teaching and mentoring skills, and to continue to provide outstanding mentorship to mentees and trainees through her research program, leveraging her leadership roles in the UAB HSR Fellowship program and the UAB Center for Outcomes and Effectiveness Research and Education to select promising candidates for training throughout the award period.
Her Research Aims are 1) to build on her current work to study the link between processes of care and outcomes for acute coronary syndrome and hear failure, by adding Medicare and Area Resource File data to the REGARDS study data, testing hypotheses generated by her current work;4 mentees will receive training while conducting these studies with the candidate;2) In the Encourage program, to conduct a pilot study that takes the next step in her intervention work, developing an intervention guided by Roger's Diffusion of Innovations theory to spread the acceptability of generic medication use via peer supporters, aiming to test the hypothesis that the intervention will improve medication adherence and, in turn, cardiometabolic risk factor levels;4 mentees will receive training and conduct these studies with the candidate. In the strongly supportive and collaborative environment of UAB, this award will permit Dr. Safford to continue to build her research program as well as capitalizing on her deep commitment to mentoring, now including six career development award recipients, as well as four T-32 fellows.

Public Health Relevance

The candidate is a successful outcomes researcher in cardiometabolic diseases. She will use the proposed award to consolidate her effort to better focus her time on continuing her success in both mentoring the next generation of cardiometabolic outcomes researchers and in growing her research program in two areas: a large prospective cohort study of cardiovascular disease, and implementation trials in real-world settings testing the effectiveness of peer support interventions to improve cardiovascular risk factors.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Special Emphasis Panel (ZHL1)
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Fine, Larry
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University of Alabama Birmingham
Internal Medicine/Medicine
Schools of Medicine
United States
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Deo, Rajat; Khodneva, Yulia A; Shlipak, Michael G et al. (2017) Albuminuria, kidney function, and sudden cardiac death: Findings from The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Heart Rhythm 14:65-71
Bromfield, Samantha G; Ngameni, Cedric-Anthony; Colantonio, Lisandro D et al. (2017) Blood Pressure, Antihypertensive Polypharmacy, Frailty, and Risk for Serious Fall Injuries Among Older Treated Adults With Hypertension. Hypertension 70:259-266
Colantonio, Lisandro D; Gamboa, Christopher M; Richman, Joshua S et al. (2017) Black-White Differences in Incident Fatal, Nonfatal, and Total Coronary Heart Disease. Circulation 136:152-166
Kent, Shia T; Rosenson, Robert S; Avery, Christy L et al. (2017) PCSK9 Loss-of-Function Variants, Low-Density Lipoprotein Cholesterol, and Risk of Coronary Heart Disease and Stroke: Data From 9 Studies of Blacks and Whites. Circ Cardiovasc Genet 10:e001632
Donnelly, John P; Safford, Monika M; Shapiro, Nathan I et al. (2017) Application of the Third International Consensus Definitions for Sepsis (Sepsis-3) Classification: a retrospective population-based cohort study. Lancet Infect Dis 17:661-670
Levitan, Emily B; Van Dyke, Melissa K; Chen, Ligong et al. (2017) Medical therapy following hospitalization for heart failure with reduced ejection fraction and association with discharge to long-term care: a cross-sectional analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) population. BMC Cardiovasc Disord 17:249
Khodneva, Yulia; Shalev, Anath; Frank, Stuart J et al. (2016) Calcium channel blocker use is associated with lower fasting serum glucose among adults with diabetes from the REGARDS study. Diabetes Res Clin Pract 115:115-21
Khodneva, Yulia; Muntner, Paul; Kertesz, Stefan et al. (2016) Prescription Opioid Use and Risk of Coronary Heart Disease, Stroke, and Cardiovascular Death Among Adults from a Prospective Cohort (REGARDS Study). Pain Med 17:444-455
Moise, Nathalie; Khodneva, Yulia; Richman, Joshua et al. (2016) Elucidating the Association Between Depressive Symptoms, Coronary Heart Disease, and Stroke in Black and White Adults: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study. J Am Heart Assoc 5:
Thacker, Evan L; Soliman, Elsayed Z; Pulley, LeaVonne et al. (2016) Investigation of selection bias in the association of race with prevalent atrial fibrillation in a national cohort study: REasons for Geographic And Racial Differences in Stroke (REGARDS). Ann Epidemiol 26:534-539

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