1. After reading the article by Thomas et al., comment on where your research, or your research interests, fit into the generational framework for health disparities research. If your work is 1rst or 2nd generation, comment on how your work could lead in the future to 3rd or 4th generation work. If your work is 3rd or 4th generation, comment on what 1rst and 2nd generation work was necessary as a foundation for your current work (or current interests).
My research is focused on identifying opportunities to improve cardiovascular outcomes in kidney transplant patients. My research has different aims. In the first aim, I will evaluate the racial disparities in prescription of cardiovascular protective medications like statins in a cohort of kidney transplant patients from FAVORIT trial. This trial is completed, and its data is publicly available. This aim of my research corresponds to 1st generation of health disparities research which is detecting the inequities. In the 2nd aim of my research, I plan to evaluate association between the cardiovascular knowledge in kidney transplant patients and implementation of cardiovascular protective strategies such as home blood pressure monitoring and compliance with medications in this population. This aim corresponds to the 2nd generation of health disparities research as we try to understand the factors contributing to the detected inequities. In the next phase of my career, I plan to develop educational interventional strategies to provide solutions to these racial disparities in cardiovascular care in kidney transplant patients; this would correspond to 3rd generation of health disparities research which is providing solutions to the detected and understood health inequities.
2. The barbershop hypertension intervention, while essentially a clinical services intervention operating at either the fence or safety-net level as described by Jones, has some engagement with the social determinants of health. Interventions like that described in the Gottleib article are designed to mitigate the impact of social determinants. How could you apply one of these two types of interventions to your area of research? Propose one or two interventions that engage with social determinants on some level.
The goal of my research is to improve the cardiovascular outcomes in the kidney transplant patients with focus on decreasing disparities in cardiovascular care in people of color. I propose an educational interventional study in which we initially screen kidney transplant patients for their cardiovascular knowledge and select those who fall in the lower score category for enrollment. Then we randomize these patients into two groups. The intervention group patients will receive in-person education about cardiovascular risk factors and lifestyle and dietary modifications these patients can pursue to mitigate the cardiovascular risk; these in-person educational activities will be tailored to patient’s ethnic background and neighborhood to be most effective. The control group will receive educational pamphlets which will contain the same educational materials on decreasing the cardiovascular risk that are taught in the in-person classes. After completion of the intervention phase, we will re-evaluate these patients’ cardiovascular knowledge and will compare the changes in the cardiovascular knowledge score between the intervention and control groups.