Mentoring in community engaged implementation research to reduce cardiovascular disparities

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PROJECT SUMMARY This is a proposal for a K24 Midcareer Investigator Award in Patient-Oriented Research (POR) for Namratha Kandula, MD, MPH of Northwestern University Feinberg School of Medicine. Dr. Kandula is Associate Professor of Medicine and Preventive Medicine and co-Director of the Center for Community Health. Dr. Kandula's scholarship is focused on understanding the social and cultural determinants of cardiovascular disease (CVD) disparities in South Asian Americans and implementing evidence-based interventions (EBIs) using community-based participatory research (CBPR) methods. South Asian Americans, the majority of whom are immigrants, are disproportionately affected by CVD compared to non-Hispanic whites and other Asian Americans. While there is ample evidence that intensive diet and physical activity interventions improve CVD risk factors in adults, these EBIs have limited reach in South Asian and other vulnerable populations because most EBIs were developed in narrow clinical populations, lack cultural salience, do not account for multilevel social determinants of health, and are difficult to implement in new settings. Dr. Kandula has expertise in epidemiologic studies and community-based lifestyle intervention trials and has been actively mentoring students and junior investigators on health disparities and community engaged research. The objective of this K24 application is to promote science and mentorship in community engaged implementation research to optimally deliver and sustain EBIs focused on populations with a high burden of health disparities. Support from the K24 will provide Dr. Kandula with protected time to: 1) Devote more time to mentoring a diverse group of young investigators in community engaged implementation research; 2) Improve her implementation science research and mentoring skills through mentor training and guidance from senior mentors; 3) Extend her currently funded work to fill critical gaps in the science of delivering and sustaining EBIs for vulnerable populations; and 4) Assume leadership in new multisector, collaborative research on how to optimally deliver EBIs to eliminate health disparities. The current K24 proposal builds upon the scientific premise and extends the research and mentorship of the PI in the context of her two NIH-funded, community engaged lifestyle intervention trials to reduce CVD disparities in South Asian adults and adolescents (SAHELI and SAATH trials). The PI and her mentees will use mixed methods to: 1) Investigate social and structural determinants that contributed to differences in implementation outcomes of EBIs in the SAHELI and SAATH trials; 2) Evaluate sustainability of the EBIs implemented in the SAHELI and SAATH trials; and 3) Understand stakeholder perspectives on which implementation outcomes and evaluation strategies are most meaningful and feasible when implementing EBIs for CVD prevention in health disparity populations. Conduct of the proposed Aims will accelerate science and mentorship in building sustainable community partnerships and models to optimally deliver EBIs that improve the health of vulnerable populations and advance health equity.