Reach Equity Career Development Award
Preterm birth (PTB), delivery prior to 37 weeks gestation, is the leading cause of neonatal mortality and morbidity resulting in life-long medical complications such as blindness, chronic lung disease and intellectual disabilities. In 2017, the US PTB rate increased for the second consecutive year reaching 9.8 percent.
Additionally, dramatic racial disparities persist such that the PTB rate is 49% higher in non-Hispanic black (NHB) women. In women with a history of spontaneous PTB, randomized controlled trails demonstrate that weekly intra-muscular (IM) injections of 17-hydroxprogesterone caproate (17-P) reduce the risk of recurrent PTB by up to one third. A recent study of 17-P adherence showed that compared to all other racial/ethnic groups, NHB women were more likely to be non-adherent8. Given both the increasing PTB rate and persistent racial disparities, it is imperative to develop patient-oriented, culturally-sensitive interventions to increase 17-P adherence in NHB women.
The overall objectives of the current application are to develop and test an intervention to address patient-perceived barriers to 17-P adherence within the clinical encounter identified by NHB women. My central premise is that targeted interventions within the clinical encounter based on patient-provided insights will lead to increased adherence to 17-P injections in NHB women who are at highest risk for both PTB and 17-P non-adherence. I am supported by a highly experienced mentorship team with expertise in PTB, intervention design and implementation. This mentorship team is coupled with a rigorous career development plan that includes coursework in disparities research methodology, intervention dissemination, research management and grantsmanship. The proposed aims and coursework will position me to attain my ultimate career goals including independent NIH research funding.