Addressing Low Cardiac Rehabilitation Participation among Patients with Low Socioeconomic Status

PROJECT SUMMARY/ABSTRACT Lena Mathews, MD, MHS is an Assistant Professor in the Division of Cardiology at Johns Hopkins University. Dr. Mathews is applying for a Mentored Patient-Oriented Research Career Development Award in order to obtain the skills, knowledge and research experience to provide the foundation for a career as an independent investigator using implementation science to address cardiovascular health disparities. Dr. Mathews’s career development plan includes interdisciplinary mentorship from Drs. Kunihiro Matsushita, Chiadi E. Ndumele, and Kristin Riekert; didactics and directed learning; and mentored clinical research adapting and implementing a theory-based multi-component intervention to increase cardiac rehabilitation (CR) use among individuals with low socioeconomic status. The specific aims of the research agenda are to: 1) Quantitatively evaluate barriers to CR referral and enrollment in a diverse hospitalized population by SES, accounting for race, gender and other sociodemographic characteristics; 2) Qualitatively elucidate perceived barriers to CR utilization in a diverse clinical population with low socioeconomic status; 3) Adapt and test the feasibility and acceptability of a navigator intervention, delivered by community health workers and refined by engagement of community stakeholders, to increase CR utilization among individuals with low socioeconomic status. She seeks to build upon her research fellowship training in epidemiology and biostatistics, and her clinical background as a Cardiologist and the Director of Cardiac Rehabilitation at Johns Hopkins, by acquiring additional skills and expertise required to achieve her career goals. This Mentored Patient-Oriented Research Career Development (K23) Award will provide her with the opportunity to: 1) develop skills in advanced epidemiology and health utilization research using electronic health records 2) develop expertise in qualitative methods, to inform intervention design and evaluation 3) develop skills in behavior change theory to develop clinical interventions that engage patients with low socioeconomic status; 4) acquire skills in implementation science methods including community based participatory research; 5) engage in additional career development activities to enable her transition to independence as a clinician-investigator. Developing these skills during the award period will support Dr. Mathews’ long-term goal of becoming an independent clinical investigator, leading efforts to improve the delivery of CVD prevention therapies to marginalized populations, with the ultimate goal of reducing CVD disparities.