CANDIDATE: Andrea Oliverio, MD, is a clinician scientist and board certified internist, pediatrician, and adult nephrologist whose long-term career objective is to improve women's health outcomes in chronic kidney disease (CKD) by developing and testing patient-centered interventions. During her career development award she will develop and pilot test a decision aid to optimize patient education and shared decision making related to reproductive health and pregnancy, while building skills to become a successful independent researcher. RESEARCH CONTEXT: More than 2 million American women live with CKD in their prime childbearing years and face numerous and unique challenges related to their reproductive health care and pregnancy decision making. Specifically, they face high risks of sexual dysfunction, reduced fertility, and poor pregnancy outcomes including progression of kidney disease, pre-eclampsia, fetal prematurity and morbidity. Proactive reproductive health care and pregnancy decision making is advocated for all women, but is particularly important for women with CKD given the risks that they and their potential offspring face.
SPECIFIC AIMS : 1) Identify information and decision-making needs of women with CKD and nephrologists related to reproductive health care and pregnancy decision making, 2) Develop a decision aid to support reproductive health care and pregnancy decision-making in CKD, 3) Pilot test and evaluate acceptability, feasibility, and preliminary effectiveness outcomes associated with use of the decision aid. RESEARCH PLAN: Dr. Oliverio will 1) use a mixed methods design to interview and survey women with CKD about reproductive health informational needs, 2) interview nephrologists regarding what they perceive as important in patient reproductive health education and care, 3) develop an EMR-integrated decision aid to support reproductive health care and pregnancy decision making, guided by International Patient Decision Aid Standards and 4) assess decision aid acceptability, feasibility, and impact on preliminary effectiveness outcomes comparing 30 patients receiving the decision aid to 30 patients receiving usual care. CAREER DEVELOPMENT PLAN: Dr. Oliverio will acquire expertise in mixed methods, advanced biostatistical approaches, decision sciences, and clinical trial conduct and evaluation to assess impact of a decision aid on outcomes. Her career development goals are supported by stellar mentorship, advanced didactic coursework, and participation in workshops and professional meetings designed to foster collaborations, ensure successful study implementation, and support her seamless transition into a successful independent researcher. ENVIRONMENT: Dr. Oliverio's unique background and skills, expert interdisciplinary mentorship, and outstanding research infrastructures at the University of Michigan and through the CureGN consortium, will leave her well-poised for success in her mentored research and establish her as a future research leader improving women's health outcomes in CKD by developing and testing patient-centered interventions.
Chronic kidney disease affects more than 2 million American women of childbearing age, and is associated with decreased fertility and increased risk of adverse pregnancy outcomes. Planning for pregnancy prior to conception is advocated for all women but is especially important for women with kidney disease because of their potential complications. This research will develop and test a decision aid that will help women and their kidney doctors share information to support informed decision making related to reproductive health care and pregnancy in women with kidney disease.
