Sarahn Wheeler, MD, has been selected for the Duke CTSA KL2 Career Development Award, a mentored research career development program for junior faculty. Each year, three Duke CTSA KL2 Scholars are selected, and each scholar is awarded 75% total protected effort for 3 years, up to $20,000/year for research expenses, and up to $2,500/year for travel to professional meetings.
Scholars are expected to complete the KL2 program equipped and inspired to become successful, independent investigators, making contributions across the entire spectrum of clinical and translational research.
Dr. Wheeler is supported by a mentorship team that incorporates experts across Duke including Geeta Swamy, MD (primary mentor); Nadine Barrett,PhD; Amy Corneli, PhD; Laura Fish, PhD; and Truls Ostbye MD, PhD, MPH. Dr. Wheeler’s project is titled “INCORPorate 17-P: EngagINg the COmmunity to Reduce PTB using 17-P” .
There is a dramatic and persistent race disparity such that preterm birth (PTB) is 49% more common in NHB women. Up to 80% of PTB is spontaneous and, among women with such a history, randomized controlled trials demonstrate a one third reduction in the PTB recurrence risk with supplemental progesterone injections called 17-hydroxyprogesterone caproate (17-P). Our preliminary data from the Duke Perinatal Clinic reveal that 45% of eligible non-Hispanic white (NHW) women received 17-P compared to only 35% of non-Hispanic black (NHB) women. Given the race disparity in PTB rates and 17-P under-utilization among NHBs, it is imperative to develop patient-oriented, culturally-sensitive interventions to increase utilization.
Analysis of our recently conducted qualitative research involving 17-P eligible NHB women suggests a lack of community-level social support including instrumental (e.g. transportation), informational (e.g. community awareness) and emotional support are important barriers to 17-P utilization. Strategic community partnerships designed to bridge resource gaps, raise awareness about 17-P and create networks for emotional support are necessary and should be evaluated as a strategy to increase 17-P utilization.
My long-term career goal is to prevent PTB and narrow the PTB race disparity by designing and implementing interventions that mitigate the patient, provider, and healthcare system level barriers to behavioral, clinical and medical PTB preventive strategies. Achieving my long term goal is impossible without skills to successfully empower and engage communities. The overall objective of the current application is to partner with key stakeholders, develop and pilot an intervention that mitigates barriers to 17-P utilization through community-level social supports. My central premise is that increased social supports via patient-oriented community-involved intervention(s), will increase 17-P utilization among NHBs.