Understanding and Addressing Racial Disparities in Guideline-Indicated Management of Symptomatic Peripheral Artery Disease

PROJECT SUMMARY 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.