Informing Health Insurance Policy to Improve Lung Cancer Screening
PI: Rebecca Myerson
This project aims to: (1) compare the effect of nearly-universal access to Medicare insurance coverage on lung cancer screening by race, sex, and ethnicity to evaluate the impact on disparities and (2) document the characteristics of screened Medicare patients who lack documentation of shared decision-making, including race, sex, and ethnicity. The findings will inform coverage policy as well as policy related to shared decision-making to improve access to lung cancer screening among older adults, women, and racial/ethnic minorities. As such, the project will increase the evidence base to improve diagnosis and make health care more accessible and equitable. Furthermore, this research will open new horizons for R01-level work on shared decision-making policy, including Medicare’s recent shared decision-making mandates for two other conditions.
Uncovering the Impact of Birth Place on Mid-Life All-Cause and Cause-Specific Mortality
PI: Wei Xu
Investigators: Jason Fletcher
This project aims to provide new evidence of the contribution of early life geographic context to variation in mid-life mortality in the US and potential mechanisms through which the contribution may be realized. Specifically, this project seeks to: (1) determine the magnitude of contribution of birth place to mid-life mortality, (2) determine the influence of birth place on patterns of mid-life cause-specific mortality, and (3) uncover mechanisms linking birth place and mid-life mortality by focusing early life exposures to epidemiologic and socioeconomic contexts and residential mobility. Findings will inform policy interventions aimed at reducing mid-life mortality inequalities.
Identification of Gene–Environment Interactions in Cognitive Decline During the Preclinical Stage of Alzheimer’s
PI: Corinne Engelman
Investigators: Yuexuan Xu
The overall objective of this proposal is to use the life-course approach, combined with a novel Alzheimer’s disease (AD) modeling strategy and rich Health and Retirement Study (HRS) and Wisconsin Registry for Alzheimer’s Prevention (WRAP) data, to identify potential interactions between social and behavioral factors, biomarkers, and genetic variants influencing cognitive aging during the preclinical stage of AD. Findings from this research will provide preliminary data for an NIH R01 application to the NIA to evaluate these candidate interactions in other NIA-funded datasets we have access to through collaborators, including expanding this research to African Americans recruited by WRAP, who were targeted in a later phase of WRAP and have just undergone genome-wide genotyping, HRS, and the Washington Heights-Inwood Community Aging Project (WHICAP).
Polygenic Gene-environment Interaction Analysis for Human Complex Traits
PI: Qiongshi Lu
Investigators: Jiacheng Miao
This study will assess the interaction between genetics and education reform (i.e., a well-known natural experiment on compulsory schooling age reform) in the UK. This project will explore two recent statistical advances as alternative approaches to estimating gene-environment interaction (GxE). This project will pursue the following two aims: (1) estimate GxE using genetic variants associated with trait variability (vQTL) and variance polygenic scores (vPGS) and (2) estimate polygenic GxE interaction using genetic correlation analysis. The analysis conducted in this project will benefit the method paper describing the PIGEON approach and will lead to at least one other manuscript on GxE analysis.
A Pilot RCT to Examine the Benefits of a Culturally Adapted Peer Support and Self-Management Intervention to Improve Glycemic Control in African Americans
The study objective is to evaluate the added value of Peers Supporting Health Literacy, Self-Efficacy, Self-Advocacy and Adherence (Peers LEAD) to Healthy Living with Diabetes (HLWD), supported by community engagement efforts, in African Americans with uncontrolled diabetes (glycosylated hemoglobin A1c ≥8%). The study aims are: (1) pilot the effectiveness of LEAD+HLWD versus HLWD for improving A1c and (2) test effectiveness of Peers LEAD+HLWD versus HLWD for increasing medication adherence for African Americans. This project will show benefits of an amplified focus on medication adherence and peer-based support to optimize A1c among African Americans. Completing the aims will address an unmet critical need to provide culturally-tailored educational content and peer support to a patient population historically beset by harms related to uncontrolled diabetes. This pilot will provide key data for the submission of a powered R01 Clinical Trial grant proposal to NIH/NIDDK, in response to PA-22-232 – Comprehensive Care for Adults with Type 2 Diabetes Mellitus from Populations with Health Disparities.
Assessing Measures of Biological Age in a Low-Income Context: The Malawi Longitudinal Study of Families and Health
PI: Lauren Schmitz
This pilot supports in-depth research on the creation and evaluation of biological (or phenotypic) aging measures in a low-income countries (LIC) context. This project has two aims: (1) construct measures of biological age (BA) in the Malawi Longitudinal Study of Families and Health (MLSFH) and test whether they are stronger predictors of age-related disease than chronological age (CA) and (2) compare BA measures and related findings with results from high-income countries (HICs) to evaluate the context-dependence of biological aging measures. This project includes the analysis of pilot data for an R01 resubmission or submission of a new R01 as well as collaborative research opportunities for students that are interested in working with the MLSFH data.