AND ABSTRACT I am an Epidemiologist and a tenure-track Assistant Professor in the Department of Surgery at the University of North Carolina at Chapel Hill (UNC). Through scholarship, I will devote my professional career to improving the care and outcomes for people with symptomatic peripheral artery disease (PAD). I have graduate training in Bioengineering (MS, ?03), Medicine, Health and Society (MA, ?10), and Epidemiology (PhD, ?16). While I have exceptional training in epidemiology methods and have a long background of conducting epidemiologic research, the majority of my previous work was in a support role and I want to pivot into areas where I lack training and expertise. The overall goal of this K01 award, therefore, is to provide me with the training and mentorship in disparities and in intervention research aimed at reducing disparities that are critical to becoming an independent scientist. To accomplish this overall goal, I have assembled a team of internationally renowned scholars with expertise in the topics and methods described in my application. My primary mentor is Dr. Samuel Cykert, an expert in health care-related racial disparities and an R01-funded investigator with experience in designing and implementing successful interventions to reduce these disparities. My co-mentor is Dr. Adil Haider, an expert in the role of implicit bias in health care-related racial disparities, and an investigator with a significant history of R-level funding. Dr. Phillip Goodney will lend his expertise and credibility as a senior-level, practicing vascular surgeon and as the Chair of the Vascular Quality Initiative Research Advisory Committee. Each of the three are fully committed to this project and to my success. The research plan is designed to first identify the presence of racial disparities in the delivery of guideline- recommended care using the nationally representative vascular quality initiative registry, a database of vascular procedures performed across 536 locations in the US. Second, I will administer the implicit association test to vascular surgeons to examine implicit racial bias and determine if those biases are correlated with actual clinical results. Finally, I will incorporate the findings from these first components of the research plan into the design of an intervention aimed at reducing disparities in the delivery of PAD-related health care. I will pilot test the intervention by assessing acceptability and utility among surgeons who care for patients with symptomatic PAD. I have recommended coursework, workshops, conferences, and other educational opportunities to round out my training. I have set up five objectives regarding career development and each of these activities is directly related to one or more of those five objectives. The successful completion of this project will lead to an R01 submission designed to test a multi-site intervention and allow me to become an independent investigator who can contribute to health equity in an area where optimal care can attenuate substantial morbidity and mortality.
We aim to identify deficits in the receipt of guideline-indicated care among black patients with symptomatic peripheral artery disease (PAD). We further endeavour to identify the specific role of physician implicit bias in the delivery of symptomatic PAD-related care and to develop a systems-based intervention to address disparate care delivery. In successfully completing this project, we will have preliminary data to support the development of a full-scale, multi-site intervention.
