Peer Support for Lowering Blood Pressure among Adolescents: A Pilot, Randomized Controlled Trial

ABSTRACT
This K01 career development proposal was developed to support Dr. Shakia Hardy, a tenure track Assistant
Professor in the Department of Epidemiology at the University of Alabama at Birmingham (UAB), in her path
towards becoming an independent researcher. The Candidate earned her PhD in Epidemiology in 2017 from
the University of North Carolina at Chapel Hill and has a strong record of published research in the fields of
cardiovascular and social epidemiology. Her goal is to integrate her epidemiology skills with implementation
science to develop an independent research program at the intersection of implementation and population
science. Dr. Hardy’s research aims to reduce health disparities in cardiovascular disease through the
modification of lifestyle behaviors that contribute to increased blood pressure in early life. Training: To
accomplish her overall goal, Dr. Hardy has proposed an intensive mentored research plan that includes
didactic education, and experiential learning in 1) intervention development, 2) implementation science for
intervention delivery and evaluation, 3) design and conduct of randomized controlled trials, and 4) leadership
skills for academic scientists. Mentorship: An interdisciplinary team of renowned scholars will mentor Dr.
Hardy and provide ongoing guidance as she transitions to independence. Her mentoring team includes a
Primary Mentor, Dr. Andrea Cherrington (Department of Preventive Medicine, UAB), co-Mentors, Dr. Paul
Muntner (Department of Epidemiology, UAB), Dr. Nathalie Moise (Department of Medicine, Columbia
University) and Dr. Daniel Feig (Department of Medicine, UAB) and two content advisors at UAB. Each of
these mentors are fully committed to this project and to Dr. Hardy’s success. Research: The prevalence of
high BP, defined as systolic BP (SBP) ≥120 mm Hg or diastolic BP (DBP) ≥80 mm Hg, is two-times higher
(20% versus 10%) among Black versus white adolescents 13-17 years of age in the US. The availability of
lifestyle behavior counseling in a clinical setting to lower BP is limited in rural communities due to long travel
distances to access healthcare, limited funds for co-payments, and ineffective provider-patient communication.
The proposed K01 addresses this gap by developing and testing the feasibility and acceptability of a peer
support intervention to lower BP among rural Black adolescents with high BP. First, Dr. Hardy will identify
aspects of the rural environment that present barriers to lifestyle behavior change. Next, using the behavior
change wheel for intervention development, she will develop and pilot test a peer support intervention devised
to address these barriers. The successful completion of this project will lead to an R01 grant submission to test
the effectiveness of this peer support intervention in a multi-site cluster-randomized trial and allow Dr. Hardy to
become an independent investigator contributing to health equity among adolescents, where lifestyle behavior
change could preempt the development of racial disparities in BP and cardiovascular morbidity and mortality.