CD04-001 Abstracts
1 K01 CD000090-01 - Informatics-based Call Centers to Investigate Outbreaks
ADVANI, ANEEL
DESCRIPTION (provided by applicant): The applicant is an Instructor in Pediatrics at Children's Hospital, Boston and a faculty member in the Children's Hospital Informatics Program. The applicant completed an NLM-funded fellowship in informatics and will be receiving a PhD in Biomedical Informatics from Stanford University this September. The applicant is also currently completing training in General Preventive Medicine and Public Health and has completed a post-doctoral fellowship in epidemiology and biostatistics at Emory University. The applicant plans to pursue a research career at the intersection of informatics and public health through a joint appointment in an academic pediatric infectious disease department and a medical informatics program. The mentor is Dr. Isaac Kohane, Director of the Children's Hospital Informatics Program division that has a staff of 40 including 15 faculty and extensive computational resources, funded through several NIH grants. We believe recent developments in information and communications technology, such as advanced knowledge-based voice recognition or hybrid decision support and analytics, could vastly improve our ability to respond to and manage large-scale outbreaks and public health disasters in the country. We propose to carry out a study identifying communication and analysis needs in public health departments and develop a system to that provides an appropriate automated solution to the outbreak investigation and management problem. Our method builds on the considerable advances in the last 5 years in the computer science of automated speech recognition and the development of the rapidly deployable call center infrastructure. We propose to build a system that can (1) provide decision support to help epidemiologists rapidly construct and analyze results from voice-enabled questionnaires and (2) use automated speech recognition-based call center technology to interview large numbers of people in very short periods of time for real-time analysis.
1 K01 DP000088-01 - Environmental Determinants of Physical Activity in Parks
BEDIMO-RUNG, ARIANE L
DESCRIPTION (provided by applicant): Dr. Bedimo-Rung is proposing a career development plan and research project to study the environmental influences of playgrounds on physical activity. This field, recently identified as social epidemiology, represents an expansion in her research focus from the individual determinants of disease to the social and environmental conditions that affect health. Her career goals are to: (1) Obtain formal training in social epidemiology, multilevel modeling, GIS, and physical activity research; (2) use her new skills to successfully compete for future grants in this area; (3) successfully achieve tenure in her current academic position while teaching and conducting research in the field of social epidemiology; (4) integrate her research findings into policy that successfully guides positive changes in health outcomes; and (5) further assist in the growth and development of the LSU School of Public Health. LSU has a strong commitment to Dr. Bedimo-Rung's research career and is able to provide release time, a research environment, and mentor resources to assist her. The proposed research project will assess physical activity before and after a planned renovation of city playgrounds. The first specific aim of the study is to evaluate, through the use of the System for Observing Play and Leisure Activity in Youth (SOPLAY) methodology, the impact of playground enhancement on: (1) The number of playground users, (2) the level of physical activity among users, and (3) the estimated energy expenditure rate within playgrounds. The second specific aim is to determine what specific features of playground environments are associated with increased physical activity among users, obtained through continued development and use of the Bedimo-Rung Assessment Tools (BRat). The third specific aim is to: (1) Provide basic demographic data on users and (2) assess user reactions to the renovated playgrounds through the use of exit interviews. The final specific aim is to design a future study to measure physical activity among children in the neighborhood population and seek further funding. The proposed application provides Dr. Bedimo-Rung with an opportunity to acquire the necessary skills in health promotion research, to apply those skills in a natural experiment, and to test innovative techniques to measure physical activity and the environment.
1 K01 IP000050-01 - Addressing Racial Disparities in Influenza Prevention
CAMERON, KENZIE A
DESCRIPTION (provided by applicant): Through this Career Development Award, Dr. Kenzie Cameron will receive the critical training and mentorship to reach her career goal of being an independent public health researcher addressing health promotion and preventive health issues. This award will allow Dr. Cameron to build on her previous experience in communication research and begin conducting funded studies in the domain of public health. Educational Aims: (1) Obtain comprehensive training in public health through pursuit of an MPH; (2) Pursue training in qualitative research, interviewing techniques, and survey design; (3) Gain knowledge and insight regarding presentation of health risk information to the lay public. Research Aims: Research has indicated that minorities are significantly less likely to be vaccinated than are whites, yet few interventions have been designed to increase vaccination rates among minorities. This study will develop two versions of a Multimedia Influenza Prevention Program (MIPP) for African Americans to determine the effects of introducing information related to influenza vaccination using a positive introductory appeal or a negative introductory appeal. The MIPP will also address concerns raised by African American participants in focus groups conducted by the CDC, particularly issues related to trust and the safety of the vaccine. The specific research aims are: (1) Develop a theory-driven Multimedia Influenza Prevention Program (MIPP) for African Americans ages 65 and older; (2) Assess the effects of using a positive or negative introductory appeal to an influenza vaccination message on African Americans' message reception, message acceptance, and intention to be vaccinated against influenza. Methods: Four waves of focus groups will address the first research aim; the second research aim will be achieved through a feasibility study consisting of pre-intervention and post-intervention interviews. Significance: The training obtained by Dr. Cameron during the award period will allow her to become a leader in the development of health promotion and disease prevention messages. The research study conducted as part of this award will be the first to develop an influenza intervention for African Americans. It will go beyond previous research on health education and prevention messages by assessing the effect of positive and negative introductory appeals. By the end of the award period, Dr. Cameron will submit an R01 application for a Randomized Clinical Trial to assess the effect of these MIPPs on vaccination behavior among African Americans at multiple study sites.
1 K01 CI000302-01 - Hepatitis B & Liver Cancer Prevention in Asian Americans
CHOE, JOHN H
DESCRIPTION (provided by applicant): This Health Protection Research Initiative Mentored Research Scientist Development Award (K01) will provide the candidate, John H. Choe, the multidisciplinary tools to become an independent investigator with special focus on hepatitis B (HBV) and liver cancer control in Asian immigrant populations. Toward this end, Dr. Choe has several related career goals that will be achieved through proposed didactic coursework, clinical training, and mentored research activities. These include: (1) To expand his cancer control research experience by serving as the mentored principal investigator in a vulnerable population; (2) To contribute to the understanding of similarities and differences of disease prevention and cancer control across different Asian populations; (3) To advance cancer control and disease prevention research methodology in Asian Americans by testing the validity of self-reported health behavior; and (4) To submit an R01 grant application addressing hepatitis B and liver cancer prevention in Korean Americans. Largely attributable to high rates of chronic HBV infection and low rates of vaccination, hepatocellular carcinoma (primary liver cancer) affects Asians more than other populations in the US. The proposed research activity would examine rates of HBV and liver cancer testing and vaccination, as well as associations with sociodemographic and other factors, among Korean Americans in Washington State; survey results from Korean Americans will then be compared with those collected previously from the Chinese American community. The research activities proposed for Dr. Choe during this mentored research career development award are: . To develop a culturally-appropriate survey instrument of HBV and liver cancer practices for Korean Americans, incorporating results from a qualitative pilot study and Bastani's Health Behavior Framework. . Using this questionnaire, to identify sociodemographic and other factors associated with recommended HBV testing among 600 ethnic Koreans from the metropolitan area of Tacoma, Washington. . To compare the similarities and differences of factors associated with recommended HBV testing across two Asian American populations: Koreans and Chinese . To conduct a supplemental analysis of the validity of self-reported HBV testing behavior by reviewing a subset of survey participant medical records among Korean and Chinese Americans. . To develop and pre-test a hepatitis B educational intervention for Korean Americans; this will provide feasibility and acceptability information for an intended R01 grant application to address liver cancer in this population.
1 K01 CE000497-01 - Public Health Model to Promote Safe Elderly Driving
CLASSEN, SHERRILENE
DESCRIPTION (provided by applicant): Older driver safety is a complex phenomenon that extends beyond the person level to multiple systems (e.g., regulatory, policy-making, societal and health care). Although a myriad of predictors for safe driving have been identified in the existing literature, they are not integrated into a meaningful causative model. Unless we use an integrated approach, grounded in a unifying public health model, we will not have taken the adequate steps to understand how behavioral, ecological, health education, administrative, policy and regulatory strategies may promote safe elderly driving. Continued neglect of these needs, accompanied with the "graying of America", could sharply increase the number of older people killed in crashes, and leave many more injured and disabled. The work I propose will develop a unifying public health model for safe elder driving. The Precede-Proceed Model of Health Promotion will provide the theoretical framework to: 1) review the current literature systematically by applying the Cochrane Collaborative Descriptive Methodology; 2) test the fit of existing population-based a) quantitative data, using epidemiological methods and structural equation modeling (SEM), and b) qualitative data using content analysis; and 3) refine the model to develop an intervention plan for safe elderly driving. This career development plan, vital to enhance my understanding of promoting safe elderly driving, includes: 1) supervised training in systematic reviews, data base analyses (SEM), model refinement and application; 2) research projects producing a narrative synthesis and meta-analysis of the older driver literature, (dis)confirmation of the Precede-Proceed model of health promotion for the older driver, and developing a pilot plan for safe elderly driving; and 3) formal didactic coursework to culminate fulfilling the requirements of this proposal. This period of supervised research and training, with the guidance from the College of Public Health and Health Professions and the College of Medicine's Departments of Epidemiology and Health Policy Research, and Biostatistics, combined with the specific supervised research proposed in this plan, will allow me to obtain novel data for application of a NIH R-03 award. This step will facilitate my transition to an independent federally funded investigator, and is directly related to my long-term goal of testing a public health model to guide a plan of assessment, prediction and promotion of safe elderly driving.
1 K01 CE000494-01 - Behavioral Health Effects of September 11th, 2001
DIMAGGIO, CHARLES
DESCRIPTION (provided by applicant): The goal of this project is to gain experience and expertise in health protection research and identify opportunities for primary and secondary prevention of terrorist and disaster-related behavioral health disturbances by assessing the effects of the terrorist attacks of 2001 on the health of New York City's communities. The applicant aims to determine whether there was an increase in emergency department or outpatient medical utilization among vulnerable populations consistent with stress-related visits and associated with an adverse affect on the overall health of the community. The research and training program involves (1) documenting past patterns of medical care utilization in post disaster periods in developed nations (2) conducting an epidemiologic study of serial demographic, clinical, diagnostic and socio-economic variables associated with outpatient and emergency department use and creating a geographic information system to compare observed vs. expected population bases rates (3) testing the hypothesis that the post-impact period is an independent risk factor for the occurrence of anxiety-related outpatient and emergency visits among vulnerable populations by utilizing epidemiologic surveillance-related statistical tools and calculating correlations and regression analyses, and; (4) examining evidence of spatial or temporal associations between the events of 2001 and deleterious effects on overall community health as indexed by public, medical, social and mental health indicators such as the occurrence of intimate partner violence. The project has implications for practitioners in responding to post-disaster behavioral health needs, public health agencies in establishing baselines for surveillance and planning for surge capacity demands, and emergency management policy makers in educating and mobilizing their communities.
1 K01 CD000049-01 - Promoting Disaster and Terrorism Preparedness in Latinos
EISENMAN, DAVID P
DESCRIPTION (provided by applicant): The goal of this K01 award is to allow David Eisenman, MD, MSHS to develop the skills to conduct community interventions for reducing disparities in health protection for terrorism and public health disasters among low-income Latinos of Mexican and Central-American descent. The award will provide an excellent transition from investigations Dr. Eisenman completed with Latino survivors of political violence and on racial/ethnic disparities in terrorism preparedness and response. The career development plan proposes mentored coursework, tutorials, and investigations to support learning in three core areas: (1) Health promotion research, (2) intervention design and analysis, and (3) terrorism and public health disasters. Latinos are disproportionately affected by disasters and terrorism. The career development activities will be applied to studies developing and testing a narrowcast marketing campaign supplemented with a community health promoter educational outreach to promote preparedness (the intervention). Dr. Eisenman will perform a needs assessment study gathering formative data from community focus groups of low-income Latinos of Mexican and Central-American descent to understand their beliefs regarding preparedness activities, barriers, preferences and facilitators to adopting and sustaining activities, and the behaviors, attitudes, and knowledge that must be addressed in the intervention. The intervention will be devised and refined using participatory research methods and a second round of focus groups. The intervention will be fielded using a quasi-experimental, non-equivalent comparison group design to test its effects and a program valuation will be performed. Results will serve as data for an R01 proposal to more fully evaluate the effectiveness of the intervention. The specific aims of this study are (1) To examine the perceived needs of low income Latinos of Central American and Mexican descent for disaster and terrorism preparedness, and identify motivators and barriers to disaster preparedness; (2) to develop, distribute, and evaluate the intervention program, and (3) to test the effects of the intervention among low income, Latinos of Central American and Mexican descent. All phases of the research will be performed in partnership with a Latino community health promoter agency and the LA Department of Public Health.
1 K01 CE000495-01 - Why Some Generations Are More Violent Than Others
FABIO, ANTHONY
DESCRIPTION (provided by applicant): Violence rates fluctuate from generation to generation. Of initial interest is whether these differences over time are due to differences between cohorts or differences in social and environmental factors. The primary question to be answered is "Why are some generations more violent than others?" It is my career goal to answer this question. My career goal is to become an independent researcher on the processes of violence trends by coupling my solid foundation of injury research and epidemiology with new skills in psychology, criminology and statistics. My aim is to further our knowledge about why violence rates change over time and bridge the gap between various disciplines to be able to assess this multi-factorial public health problem. Empirical explanations are still longing on the major public health problem of why the level of violence fluctuates over time. Major limitations of these studies include the exclusion of confounders, not utilizing true longitudinal data, and the presence of both the ecologic and individualistic fallacies. Currently violence trends are not clearly understood and a diversity of contrasting explanations exists, including increased prevalence in certain age cohorts (cohort effect) and social risk factors occurring during certain periods of time (period effect). A major reason that so many explanations exist is that the causes for violence trends are multifactorial and occur at different levels - e.g., the community and the individual. The study of these various factors and levels are rooted rather independently in various public health, sociologic, and medical disciplines. The training program I propose will provide me with additional skills in (1) developmental psychology, (2) criminology and (3) advanced statistics through classes, seminars, and one-on-one training with my career development committee. We have conducted initial analysis of the PYS through our first generation model and have found that cohort effects are rendered insignificant by period effects, suggesting the importance of social factors on violence trends. My research program proposes a series of analyses culminating in the development of a second-generation model - our proposed contextual-developmental model for violence. This model will expand on the known individual developmental pathways developed by Rolf Loeber my mentor for this proposal, by the inclusion of social and environmental factors. Knowledge from these aims and from future work stemming from this proposal can be used to help integrate public health and criminal justice prevention programs into an overall program that will be more effective than many efforts in the past (49). Primary, secondary, and tertiary strategies aimed at the human, environmental, and instrumental elements of violence will ultimately be possible.
1 K01 PS000066-01 - Computer Assisted Rx Education for HIV-Positives: Care+
KURTH, ANN E
DESCRIPTION (provided by applicant): Candidate: Ann Kurth is Assistant Professor at the University of Washington (UW). She has an MPH (Columbia), MSN (Yale), and PhD (Epidemiology, UW). Her immediate goal is to obtain training in information technologies for health promotion to HIV-positive individuals. Her career goal is to build, an independent research program that uses these technologies to systematically address the health protection needs of vulnerable populations. Educational Plan: UW is well-established in HIV and informatics research, making it ideal for advanced studies in this area. Dr. Kurth's primary sponsor is King K. Holmes, MD, PhD. Research Plan: Helping HIV-positive individuals to adhere to their antiretroviral treatment (ART) and to prevent HIV transmission will improve the nation's health by reducing HIV morbidity, mortality, and drug resistance. Since these behaviors are dynamic, innovative interventions are needed over time. Computer tools offer such a strategy. We will adapt and evaluate a 'Computer-Assisted Rx Education for HIV-Positives: CARE+' tool whose purpose is to deliver an integrated ART adherence and HIV transmission risk reduction intervention at the UW HIV clinic and at an AIDS service organization. CARE+ will build on a successfully developed software platform and will comprise risk assessment, medication monitoring, tailored feedback, stage-based skills-building videos, motivational interviewing counseling, an integrated health promotion plan, and printout with referrals. Aim 1: Identify common elements of adherence and transmission behaviors, health communication needs, and technology attitudes (n=30 interviews); incorporate into CARE+ and test usability (n=30). Aim 2: Randomized clinical trial of HIV-positive adults on ART. Arm 1: CARE+ (n=70); Arm 2: computer risk assessment (n=70, to control for intervention effect of assessment); Arm 3: standard of care encounter (n=70). Arms 1 and 2 perform baseline, 3-, 6-, and 9-month sessions; Arm 3 undertakes computer risk assessment at 9 months. Compare outcomes: a) adherence by plasma HIV viral load and b) HIV transmission risk behaviors. Aim 3: Provide data for HIV transmission dynamics impact modeling.
1 K01 DP000085-01 - Cardiovascular Disease Trends in the Elderly
LICHTMAN, JUDITH H
DESCRIPTION (provided by applicant): Despite the recognition of cardiovascular disease (CVD) as a leading cause of mortality, this country lacks a cohesive, informative surveillance system that can provide insights into national patterns of care, reveal national trends over time, and track short- and long-term patient outcomes for elderly Americans. Most national estimates of CVD and outcomes have been based on extrapolating rates from a very small number of community studies or clinical studies that are restricted in terms of size, demographics, or geography. In addition, outcome measures have most often been limited to recurrent disease or death, and typically consider short-term outcomes (rarely beyond 12 to 24 months). Related vascular events and nonvascular events are rarely considered. This has resulted in significant data gaps. Defining patterns and trends of CVD, and identifying differences and disparities among diverse groups in terms of age, race, gender, clinical history, as well as different geographic regions of the United States should be a top research priority. We have created a population-based national cohort that will begin to fill these gaps in knowledge. The Cardiovascular Disease Trends in the Elderly Study will span 12 years and include all fee-for-service Medicare beneficiaries discharged with CVD from 1991 through 2003. Accordingly, this study has the following specific aims: (1) Determine 12-year cardiovascular disease trends, especially by age, race, and gender subgroups, as well as region; (2) determine the short- and long-term outcomes for patients hospitalized with cardiovascular disease; and (3) determine the change in cost and outcomes for Medicare beneficiaries. This career development award will enable the candidate to build additional skills to link the complementary disciplines of clinical medicine, epidemiology, public health, biostatistics, and health economics to examine the burden of cardiovascular disease in the elderly. This unique perspective will provide valuable insights for policy makers and investigators in planning for the health care needs of patients with established cardiovascular disease.
1 K01 EH000066-01 - Community Design and Public Health
LITT, JILL SUZANNE
DESCRIPTION (provided by applicant): The global hypothesis of this research proposal is that physical and social changes in the community will lead to improved health and well-being of residents. "Community Design and Health: Starting from the Ground Up" will study an established community recreational activity, community gardening, for its potential to promote public health through increased physical activity, nutrition, social engagement, and cognitive stimulation with the long-term public health goals of disease prevention and health promotion. The broader focus of our research activities extend beyond gardens, which are simply an advantageous model for addressing our global hypothesis as stated above. The data we collect and the tools we employ will provide important information to facilitate community change by strengthening the evidence base around community interventions and providing much needed information to our community partners and local planners regarding the connection between community design and public health and the role of local green space in shaping health status. This project is designed as a mentored research opportunity for the candidate to develop expertise and a diverse set of skills drawing on the sciences and tools of architecture and planning and behavior sciences together with skills in epidemiology and environmental health to craft and evaluate interventions that seek to promote active living and well-being in different behavior settings. This project will be conducted collaboratively with Denver Urban Gardens (DUG), Groundwork Denver (GWD), and Front Range Earth Force (FREF), three community organizations with many years of service to Denver neighborhoods.
1 K01 EH000065-01 - Birth Weight and Other Risk Factors of Childhood Asthma
LU, HSIEN-HEN
DESCRIPTION (provided by applicant): The long term objective of this propose project is to investigate how childhood health are determined, how childhood health can affect adulthood health and later life chances, and how these are translated into the next generation well-being. The goal of the proposed study is to investigate relationships between birth weight and childhood asthma and how environment and experiences during childhood can moderate that relationship. There are three specific Aims of the proposed study: Aim I: To estimate the association between low birth weight and the risk of asthma among children (0-17) net of observable family and community backgrounds by using the nationally representative data. Aim II: To estimate the association between low birth weight and the risk of asthma among children by using a sibling model to control for unobservable background factors. Aim I To estimate the impacts of changing maternal risk behavior (such as smoking), family structure, residence area, and other familial and environmental factors during childhood on the risk of asthma by using panel models. Aim IV: To examine whether the estimated association between low birth weight and asthma is moderated by potential changes in disadvantage, whether in parental risk behavior, family structure, residence area, or other familial and environmental factors during childhood by using sibling models. To examine whether the estimated association between low birth weight and asthma is moderated by disadvantaged changes in parental risk behavior, family structure, residence area, and other familial and environmental factors during childhood by using sibling models. Two nationally representative data are used National Health Interview Survey (NHIS) and the National longitudinal Survey of Youth 1979 cohort children Data (NLSY79-CD). By using the NHIS data, the association between low birth weight and the chance of asthma among children could be investigated. With the NLSY-CD data, panel data models and sibling models are applied to control for unobserved factors for children and their siblings.
1 K01 CI000301-01 - Genetic and Environmental Factors in PCV7 Vaccine Effect
MAHON, BARBARA E
DESCRIPTION (provided by applicant): The purpose of this K01 application is to support a period of didactic training and mentored research on the genetic epidemiology of childhood invasive pneumococcal disease (IPD). Dr. Mahon, who received her MD from UCSF, her MPH from DC Berkeley, and trained as an EIS officer in the Foodborne and Diarrheal Diseases Branch, has recently focused her career on vaccine-preventable diseases. Her position as Assistant Professor of Epidemiology and Pediatrics at the Boston University (BU) Schools of Public Health and Medicine has allowed her to draw upon two areas of research excellence at BU-childhood pneumococcal disease, which has been a decades-long focus within the Division of Pediatric Infectious Disease, and statistical genetics, in which the Department of Biostatistics has great depth and breadth. Her mentors, Stephen Pelton, MD and L. Adrienne Cupples, PhD, are the chief and chair of these groups, respectively. Dr. Mahon is seeking didactic and research training to expand upon her existing expertise in epidemiology in order to conduct studies of genetic factors involved in susceptibility to invasive pneumococcal disease (IPD) and in the protective response to the heptavalent pneumococcal conjugate vaccine (PCV7). She will conduct three studies of the role of candidate genes involved in pneumococcal disease and vaccine response using cases of childhood IPD detected through enhanced laboratory-based public health surveillance in Massachusetts. The first study is a family-based association study, conducted with cases and their families, of the association of the candidate genes with IPD. The second study is a case-control study, conducted with the same cases and with unrelated child controls with nasopharyngeal pneumococcal colonization, of the association of the same candidate genes with IPD. The third study examines the association of the candidate genes for PCV7 vaccine response with the occurrence of PCV7 failure, using both siblings of cases and unrelated colonized controls as comparison groups. Each study will control for possible confounders, such as underlying illness and tobacco smoke exposure. The ultimate goal of these projects is to improve understanding of why IPD continues to occur and to develop Dr. Mahon's capability to independently extend this research to address genetic issues in the control of vaccine-preventable diseases
1 K01 CI000300-01 - Prevention of Healthcare-Associated Drug-Resistant GNR
MARAGAKIS, LISA L
DESCRIPTION (provided by applicant): Dr. Maragakis is an infectious disease fellow at the Johns Hopkins University whose research is in the area of hospital epidemiology and infection control under the mentorship of Dr. Irish Perl. Through this award, Dr. Maragakis will conduct epidemiologic research on healthcare-associated antimicrobial-resistant gram negative rods (GNR) as a faculty member of the Division of Infectious Diseases at Johns Hopkins. She will continue to have the mentorship of Dr. Perl, an expert in epidemiologic and infection control research, and will also have the mentorship of Dr. Karen Carroll, an expert in microbiologic research. To complement her research and acquire skills to become an independent researcher, Dr. Maragakis will complete courses in the School of Public Health in epidemiology, biostatistics, ethics, and research methods. Antimicrobial-resistant GNR are a growing threat to patients and treatment options for these infections are limited. We hypothesize that healthcare-associated transmission of these organisms occurs not only among patients at a single institution, but among multiple healthcare institutions in a community, and that a strategy of targeted active surveillance will decrease their incidence. Dr. Maragakis' preliminary data show that strains of resistant Acinetobacter from The Johns Hopkins Hospital match strains from other healthcare facilities in Baltimore and that prior residence in a long-term care facility was a significant risk factor for acquisition of the organism in the hospital. Through this award, she proposes to determine the incidence of antimicrobial-resistant Acinetobacter and Pseudomonas in one acute care hospital, two community hospitals, and two long-term care facilities in the Baltimore area. She will then use molecular techniques to characterize the strains and will correlate this information with patient movement between the institutions. Finally, she will evaluate targeted active surveillance as a strategy to reduce transmission of these organisms within The Johns Hopkins Hospital. The combination of research, coursework in the School of Public Health, excellent mentorship of senior investigators, and the supportive environment at The Johns Hopkins University will provide Dr. Maragakis with the skills she needs to develop into an independent clinical investigator in epidemiologic research for the prevention of healthcare-associated infections.
1 K01 CD000196-01 - School-based Emergency Preparedness
RAMIREZ, MARIZEN
DESCRIPTION (provided by applicant): This application for a K01 Mentored Research Scientist Development Award is to obtain three years of support for education and research activities to develop a career in school emergency preparedness. In light of the recent events of September 11, 2001 World Trade Center bombing and the March 11, 2004 train bombing tragedy in Madrid, Spain, the need for coordinated emergency preparedness and response planning has been emphasized in all sectors of the community. The education sector is a location where children, one of the most vulnerable members of our population, may be severely affected during emergencies and disasters, and hence is the focus of the Applicant's proposed training and research. Through the support granted by this Career Development Award, the Applicant seeks to become an expert scientist in school emergency preparedness by participating in two primary activities: (1) Rigorous training in emergency preparedness theories and in methods for analyzing and evaluating qualitative and quantitative data on emergency preparedness and (2) conducting research with Compton Unified School District to study the types of emergencies experienced by the 39 Compton schools; identify the school emergency preparedness activities; measure perceptions of students, staff, and parents; and identify potential measures for evaluating the effectiveness of preparedness activities. The Applicant will be guided by a cadre of individuals from academia, emergency management, and the school community with expertise in school safety, infectious disease, community emergency response and preparedness, epidemiology, disaster research, qualitative and evaluation methods, adolescent behavior, pediatrics and injury prevention. The findings from her proposed project have implications for improving the training and preparedness activities in schools.
1 K01 DP000089-01 - Health Values and Treatment of Pediatric Type 2 Diabetes
RHODES, ERINN
DESCRIPTION (provided by applicant): The professional development goal of this K01 award is to permit Dr. Rhodes, a pediatric endocrinologist with training in health services research, to develop expertise in research methods and disciplines that she will use to develop health promotion and disease prevention strategies for children with and at risk of Type 2 diabetes (T2DM). These methods and disciplines include assessment of health preferences, use of decision analysis, and health communication. Dr. Rhodes will achieve this goal through coursework, mentorship, and supervised research in collaboration with experts in pediatric obesity, pediatric diabetology, and decision science. This training will be a critical step in ensuring Dr. Rhodes' successful transition to an independent public health researcher. The scientific goal of this project is to evaluate the role of health preferences (values) in the treatment of T2DM in children. T2DM and its complications, though preventable, increasingly threaten youth, especially racial/ethnic minorities. Inadequate consideration of patients' health preferences in the design of clinical interventions may explain the apparent gap between the potential efficacy and actual effectiveness of these interventions. However, the preferences of children with T2DM for health states affected by their disease have not been described. Therefore, the aims of the research are: (1) To describe and compare the health preferences of adolescents with T2DM and their parents for key health states associated with T2DM using standard decision analytic methods, (2) to evaluate the association between child and parent concordance in ranking of preferences for T2DM-related health states and the child's glycemic control, (3) to evaluate the association of race/ethnicity with these preferences, and (4) to develop a decision analytic model of T2DM treatment in childhood that compares the long-term benefits of various treatment alternatives and that can determine whether recommended treatments are consistent with families' stated preferences. Dr. Rhodes proposes to conduct this research as an ancillary study to the TODAY study, an ongoing multicenter trial of treatments for T2DM in childhood. This importantresearch will assist Dr. Rhodes in advancing toward her long-term goal of improving the health and quality of life of children with and at risk of T2DM.
1 K01 DP000087-01 - Effectiveness of a free nicotine patch program among Chinese Americans
SHELLEY, DONNA R
DESCRIPTION (provided by applicant): The current proposal is an application for a mentored scientist award in tobacco control research (K01). The applicant is a physician with a master's degree in public health. This proposal intends to serve as a bridge to an independent investigator career in transdisciplinary tobacco control research through a period of mentored activities and the development of new methodological skills within the context of a strong quasiexperimental research design. The framework for the proposal is the NCI funded NYC Chinese Health Study; a population based longitudinal study with a representative sample of 2537 Chinese Americans living in two communities in NYC. The study is examining tobacco use behaviors and other health indicators among this immigrant population. The baseline survey was completed in 2003 with the follow-up survey to be implemented in May 2005. The timetable of the Chinese Health study coincides with the timetable of the K01 award and implementation of a NYC Department of Health population-based free nicotine patch program. The proposed research plan takes advantage of this natural experiment and the opportunity for questionnaire modification and development of new hypotheses and analytic models within the longitudinal quasi-experimental design of the Chinese study. The principle aim of the proposal is to estimate the population and individual-level impact of a free nicotine program on the use of pharmacotherapy and cessation rates in this minority immigrant population. In addition I will examine determinants of medication use and cessation among Chinese Americans who participate in nicotine replacement therapy, including behavioral, cognitive, social, and cultural factors.
1 K01 CE000496-01 - Acculturation and Health Protection in Latino Youth
SMOKOWSKI, PAUL R
DESCRIPTION (provided by applicant): The candidate, Dr. Paul Smokowski, is an Assistant Professor in the University of North Carolina at Chapel Hill's (UNC-CH) School of Social Work. He has served as Co-Principal Investigator on youth violence research grants funded by NIDA and the CDC. His career goals are as follows; (1) establish himself as an interdisciplinary public health scholar with a national recognition for research on Latino adolescent health and mental health, (2) become a rigorous mixed-methods researcher, and (3) secure RO1 funding for a multi-state study of acculturation and health behaviors in Latino adolescents. The candidate's research career development plan includes receiving mentoring from Professors Mark Fraser, a nationally known scholar on risk and resilience in children and adolescents, Carol Runyan, a leading public health researcher on injury control, and Flavio Marsiglia, an expert on acculturation and adolescent substance use. He will take advanced coursework in the UNC-CH School of Public Health, focusing on adolescent health and research methodology. He will also become a core member of UNC-CH's Injury Prevention Research Center (IPRC). The training environment draws resources from UNC-CH's School of Public Health, School of Social Work, IPRC, and Arizona State University's Southwest Interdisciplinary Research Consortium. The aim of the proposed investigation is to study acculturation, health protection, and health risk behavior in Latino adolescents residing in North Carolina and Arizona. This investigation will map modifiable risk factors that lead Latino adolescents to engage in negative health behaviors such as alcohol, tobacco, and drug use, aggressive behavior, and suicide. Using a prospective, longitudinal design, 300 Latino adolescents (150 in NC, and 150 in AZ) will be assessed 4 times over 3 years. Mixed-methods analyses using HLM growth curve modeling, and qualitative interview data will examine how acculturation processes and health behaviors evolve over time in different environmental settings.
1 K01 DP000090-01 - Cultural Influences on Health Beliefs and Practices
TEAL, CAYLA R
DESCRIPTION (provided by applicant): The primary purpose of this proposal is to provide the candidate with the training, mentorship, and environmental structure to develop a scientific understanding of the cultural influences on health beliefs, decision-making, and practices, as they relate to well-documented racial and ethnic health disparities. Short-term career development goals include acquiring a broader knowledge base regarding health disparities, population-based cultural norms, health-related decision-making, and health promotion. Intermediate goals include examining race and ethnicity as a proxy variable for understanding disparate health outcomes and the development of a multidimensional instrument for measuring cultural factors that are related to health. Long term goals include becoming an independent researcher with a research agenda focusing on the role that culture plays in health and health disparities, and ultimately, on the development of evidence-based health promotion programs and health system practices that incorporate cultural information. The candidate will build upon existing research skills in measurement, instrument development and community-based research with minority populations. The proposed career development program integrates a structured mentoring program with a panel of local and national expert advisors. To facilitate the candidate's development, the program utilizes formal course work in public health and medical anthropology, well-established minority health and health disparities training workshops and conferences, involvement with community-based health coalitions, research conferences, and research collaborations. In the health literature, several models have been used to describe the mechanisms by which individual factors such as race and ethnicity can influence health behavior and ultimately, health outcomes. In her research, the candidate proposes to examine cultural factors that influence individual characteristics, such as health beliefs, decision-making, and practices, and are a possible contributor to racial and ethnic disparities. To date, no direct measure of culture (for any cultural, racial or ethnic group) exists. To carry out these long-term goals, it is essential that a measure that captures the multidimensional nature of culture and that can be used with different racial and ethnic groups be developed. The proposed research is designed to meet this need through community-based recruitment that utilizes consultation and assistance from three well-established racial and ethnic health coalitions. Both qualitative and quantitative research methods will be used in the instrument development phases. The final phase of the project will examine the psychometric properties of the instrument and include a preliminary examination of the relationship between culture and health beliefs, practices, and decision-making, as well as associated health status and outcomes.
1 K01 DP000086-01 - Health Communication and Risk Processing Among Smokers
VIDRINE, JENNIFER IRVIN
DESCRIPTION (provided by applicant): The construct of risk perception occupies a key rote within most major theoretical models of health behavior. However, empirical evidence supporting the relationship between high levels of perceived risk and the practice of risk-reducing behaviors is often inconsistent. Surprisingly little is known about factors that may influence the construction of risk perceptions, how perceptions of risk may change over time, or about how smoking behavior and risk perceptions may be reciprocally related. The proposed study will address these issues by examining real-time, momentary changes in risk perceptions in the natural environment among smokers attempting cessation. Moreover, the study will examine potential differences over time in perceptions of risk among smokers who achieve successful abstinence and those who relapse. Participants will be community smokers (N=200) recruited from the greater Houston area. We expect that factors including affective state, craving, and smoking behavior will influence perceptions of smoking-relevant risk over time in the natural environment. Participants will be tracked from one week prior to their quit date through three weeks after their quit date using state-of-the-science ecological momentary assessment (EMA) procedures. All participants will receive smoking cessation treatment consisting of nicotine patch therapy, minimal contact smoking cessation counseling, and self-help materials based on the Treating Tobacco Use and Dependence Clinical Practice Guideline. Smoking-relevant health risk perceptions will be assessed using several state-of-the-science behavioral/psychological assessment technologies - EMA and "implicit" cognition psychological measures - as well as computer-administered questionnaires. Findings have the potential to shed light on important mechanisms that may influence the construction of risk perceptions and on how perceptions of risk and smoking behavior may be reciprocally related.
1 K01 EH000067-01 - Improving Health Literacy to Reduce Disparities
WOLF, MICHAEL S
DESCRIPTION (provided by applicant): Disparities in asthma morbidity and mortality by race/ethnicity and socioeconomic status (SES) have been repeatedly documented. Low literacy may contribute to asthma disparities, yet prior asthma interventions have not satisfactorily addressed this literacy barrier; even though as many as half of adults living with asthma and caregivers to children with asthma have limited literacy skills. Multimedia and enhanced print materials may be effective bridge tools to help community asthma workers and pharmacists convey asthma knowledge and teach proper self-management in a manner that is accessible to a lower literate audience. The purpose of this research is to support the mentorship and research training of Dr. Michael Wolf at Northwestern University to develop Asthma Self Management Enabling (ASME) Materials that target education and empowerment messages to inner-city adults with asthma or caregivers to affected children to 'prime' these individuals to maximize their benefit from asthma self-management programs. The ASME materials will include a multimedia program and "enhanced print" handout; both designed to be accessible to a lower literate audience and be culturally appropriate. Training and research activities will be nested in an ongoing study led by the Primary Sponsor of this proposal (K. Weiss), and will include: 1) analyses of longitudinal data to better understand direct and indirect pathways through which literacy and cultural influences impact asthma self-management behaviors, 2) Use findings from those analyses to guide qualitative research activities for the development, refinement, and pilot testing of the ASME materials, and 3) field test the ASME materials among adults with asthma and caregivers to children with asthma, to see if the materials improve coping, knowledge, and self-efficacy. Findings from this research will support grant submissions for a more substantial evaluation of the materials; I will also explore opportunities to translate this methodology to the self-management of other chronic diseases.
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Page last modified: July 22, 2008
Content source: Office of the Chief Science Officer (OCSO)
