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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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
Limdi, Nita A; Howard, Virginia J; Higginbotham, John et al. (2016) US Mortality: Influence of Race, Geography and Cardiovascular Risk Among Participants in the Population-Based REGARDS Cohort. J Racial Ethn Health Disparities 3:599-607
Bhatt, Hemal; Gamboa, Christopher M; Safford, Monika M et al. (2016) Is there an association between the prevalence of atrial fibrillation and severity and control of hypertension? The REasons for Geographic And Racial Differences in Stroke study. J Am Soc Hypertens 10:578-586.e5
Colantonio, Lisandro D; Bittner, Vera; Reynolds, Kristi et al. (2016) Association of Serum Lipids and Coronary Heart Disease in Contemporary Observational Studies. Circulation 133:256-64
Colantonio, Lisandro D; Gamboa, Christopher M; Kleindorfer, Dawn O et al. (2016) Stroke symptoms and risk for incident coronary heart disease in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Int J Cardiol 220:122-8
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 26:534-9
Mondesir, Favel L; Brown, Todd M; Muntner, Paul et al. (2016) Diabetes, diabetes severity, and coronary heart disease risk equivalence: REasons for Geographic and Racial Differences in Stroke (REGARDS). Am Heart J 181:43-51
Ghazi, Lama; Safford, Monika M; Khodneva, Yulia et al. (2016) Gender, race, age, and regional differences in the association of pulse pressure with atrial fibrillation: the Reasons for Geographic and Racial Differences in Stroke study. J Am Soc Hypertens 10:625-632.e1
Curtis, Jeffrey R; Bharat, Aseem; Chen, Lang et al. (2016) Agreement between Rheumatologist and Patient-reported Adherence to Methotrexate in a US Rheumatoid Arthritis Registry. J Rheumatol 43:1027-9
Bhatt, Hemal; Gamboa, Christopher M; Safford, Monika M et al. (2016) Prevalence of electrocardiographic abnormalities based on hypertension severity and blood pressure levels: the Reasons for Geographic and Racial Differences in Stroke study. J Am Soc Hypertens 10:702-713.e4

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