Candidate: I am a neurologist who has undertaken post-doctoral fellowship training in measuring patient outcomes and methods of patient-oriented research, obtaining a Master's Degree in Health Services from the UCLA School of Public Health. I have applied my formal research training to design and successfully complete studies that show suboptimal secondary stroke prevention, using local, regional and national datasets. My immediate-term goal is to further develop my research skills in designing and testing care delivery interventions to improve outcomes of stroke patients. My long-term goal is to become an expert in reducing disparities of health and health care among persons with neurological disease. Research career development plan: My sponsor is Dr. Barbara Vickrey, the leading expert in patient outcomes measurement and care delivery interventions for neurological conditions. My co-mentor is Dr. William Cunningham, an expert in outcomes research and disparities of health among minority populations. Over a 5-year period, I will attend courses and seminars on trial design, program evaluation, implementation skills, disparities research, and ethics through UCLA School of Public Health, the VA Greater Los Angeles Healthcare System, and the NCMHD-funded UCLA/Drew Project EXPORT. Description of research project: I will design and implement a novel care delivery intervention based on the Chronic Care Model that includes group clinics, self-management education, and coordination of care. I will test it at a VA Los Angeles hospital through a RCT of 230 patients with cerebrovascular disease. Primary study outcome measures, collected at baseline and at six months after enrollment, will be control of stroke risk factors. In a second phase, I will adapt and implement the VA intervention to fit the needs and available resources at a nearby county hospital, serving an indigent minority population in South Los Angeles. I will perform a formative evaluation in preparation for a future RCT at that setting. Relevance: This application supports the career development of a neurologist to develop and test of a new model of healthcare delivery to prevent stroke among high-risk patients. It will be tested in a VA and implemented in an indigent minority community in Los Angeles. ? ? ?
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