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Understanding immigrants' cardiovascular disease utilization: An epidemiological and system dynamics approach

Award Number: K01HL174891
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/01/2024
PERIOD OF PERFORMANCE END DATE: 08/31/2029

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Understanding immigrants' cardiovascular disease utilization: An epidemiological and system dynamics approach - Cardiovascular disease (CVD) is one of the leading causes of mortality in the U.S. When immigrants first arrive in the U.S., they have better CVD risk factor profiles than the U.S.-born, but within 5 to 15 years of living in the U.S., they experience a worsening of their CVD risk factor profiles. Some immigrants have lower screening, monitoring, and treatment of CVD risk factors than U.S.-born populations. Lower preventive care utilization likely contributes to their worsening cardiovascular health. Eliminating differences in CVD preventive care utilization is necessary to improve the cardiovascular health trajectory of immigrants and lessen the burden of CVD mortality in the U.S. The research objective of this career development award is to use epidemiologic, system dynamics, and community-engaged methods to understand how individual and multiple components of the environment (e.g., language barriers, provider accessibility, social incorporation) affect immigrants’ CVD preventive care utilization. This research will also address current gaps in research by focusing on CVD preventive care utilization outcomes and using objectively measured, longitudinal electronic health record data (EHR). The research objective will be achieved through three novel aims. Aim 1 is to estimate trends and associations between state and county-level measures of social incorporation (e.g., language access in health care settings) and CVD preventive care utilization among immigrant adults using electronic health record data from a nationwide network of community health centers. Aim 2 is to develop a system map with community stakeholders that graphically depicts hypothesized causal relationships and feedback loops within the environment that affect immigrants’ CVD preventive care utilization. Aim 3 is to develop a system dynamics simulation model to estimate improvements in CVD preventive care utilization as different components of the environment are manipulated. This multidisciplinary research plan directly addresses NHLBI’s critical challenge to advance methods of assessing and characterizing exposures to understand differences in health among populations. The research aims are complemented with a training plan that builds upon the candidate’s expertise as social epidemiologist to develop the candidate’s expertise in the (1) measurement and quantification of components of the environment, (2) analysis of longitudinal EHR data, (3) use of system dynamics simulation methods, and (4) use of community-engaged research and community-based system dynamics methods. Together, the research and training plans will prepare the candidate to become an interdisciplinary, independent research investigator whose career is aimed at improving the cardiovascular health trajectories of immigrants in the U.S,


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $160,977 )
2026	2026	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	3	9/8/2026	NON-COMPETING CONTINUATION	$160,977
														Subtotal = $160,977

Issue Date FY: 2025 ( Subtotal = $161,856 )
2025	2025	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	2	9/8/2025	NON-COMPETING CONTINUATION	$161,856
														Subtotal = $161,856

Issue Date FY: 2024 ( Subtotal = $162,000 )
2024	2024	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	1	8/20/2024	NEW	$162,000
														Subtotal = $162,000

Grand Total All Awards = $484,833

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Understanding immigrants' cardiovascular disease utilization: An epidemiological and system dynamics approach

Award Number: K01HL174891

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/01/2024

PERIOD OF PERFORMANCE END DATE: 08/31/2029

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