T32 Multidisciplinary Research Training to Reduce Inequalities in Cardiovascular Health (METRIC)


The “Multidisciplinary Research Training to Reduce Inequalities in Cardiovascular Health (METRIC)” utilizes a multidisciplinary approach and a mentor-based model to train diverse pre-doctoral and post-doctoral candidates in the study of broadly defined inequalities in cardiovascular health and health care, based on factors such as race/ethnicity, sex/gender, socioeconomic status, geographical residence, among others. The program is designed to prepare outstanding candidates for a successful research career that will ultimately help reduce health disparities in cardiovascular disease. 

The METRIC T32 training grant is housed in the Department of Epidemiology, and draws faculty with diverse expertise and at various career stages from all Emory Schools (School of Public Health, School of Medicine and School of Nursing) and Morehouse School of Medicine. The Program Director is Dr. Viola Vaccarino in the Department of Epidemiology. The Program Co-Director is Dr. Arshed Quyyumi in the Department of Medicine.

The program combines training in graduate degree programs in the School of Public Health with multidisciplinary research experiences working with top investigators in cardiovascular sciences from diverse disciplines, from basic sciences to epidemiology, cardiology, interventions, and health policy. 

Training of pre-doctoral and post-doctoral fellows will include multidisciplinary mentoring along with coursework, inter-departmental seminars, hands-on research, and career development. Training will emphasize public health relevance, prevention and translation from basic sciences to epidemiology, clinical research, health policy and implementation, with the ultimate goal of reducing inequalities in health and health care. A maximum of 4 pre-doctoral and 4 post-doctoral trainees will be in the program at any time point, each supported for an average of two years. 

Ali, Mohammed, MBChB, MSc, MBA, RSPH, Global Health - Cardiometabolic disease epidemiology, implementation sciences, global health

Alonso, Alvaro, MD, PhD, RSPH, Epidemiology - CVD Epidemiology, cardiac arrhythmias, neurodegenerative diseases

Arriola, Kimberly, PhD, RSPH, Behavioral Sciences - Minority health, women’s health, health inequities, health behaviors, community health, intervention and implementation sciences

Bremner, J. Douglas, MD, Emory SOM, Psychiatry - Mental health, neurobiology of stress

Cooper, Hannah, PhD, RSPH, Behavioral Sciences - Social determinants of health, minority health, health inequities, community health, geospatial, multilevel analysis

Corwin, Elizabeth, RN, PhD, Emory SON - Minority health, health inequities, women’s health, mental health

Dickert, Neal, MD, PhD , Emory SOM, Medicine (Cardiology) - Cardiovascular medicine, bioethics, public health ethics

Druss, Ben, MD, MPH, RSPH, Health Policy - Mental health, health services, health policy

Dunbar, Sandra, RN, PhD, Emory SON - Health behaviors, psychosocial factors, intervention research

Gazmararian, Julie, PhD, RSPH, Epidemiology - Social determinants of health, health behaviors, nutrition, obesity, health policy, community health, implementation sciences

Griendling, Kathy, PhD, Emory SOM, Medicine (Cardiology) - Vascular biology, molecular biology

Hajjar, Ihab, MD, Emory SOM, Geriatrics - Vascular biology, aging, health disparities

Hogue, Carol, PhD, RSPH, Epidemiology - Women’s health, minority health, health inequities

Jones, Dean, PhD, Emory SOM, Pulmonary - Metabolism, nutrition, metabolomics, redox mechanisms

Kegler, Michelle, PhD, RSPH, Behavioral Sciences - Health behaviors, obesity, community-based participatory research, implementation sciences

Kramer, Michael, PhD, RSPH, Epidemiology - Epidemiology methods, social determinants of health, geospatial analysis, multilevel analysis

Kutner, Michael, PhD, RSPH, Biostat+Bioinformatics - Biostatistics/bioinformatics

Lash, Timothy, MPH, DSc, RSPH, Epidemiology - Epidemiology methods, molecular epidemiology

Lewis, Tené, PhD, RSPH, Epidemiology - Social determinants of health, CVD epidemiology, minority health, health inequities, women’s health, psychosocial factors

Lim, S. Sam, MD, Emory SOM, Rheumatology - Minority health, chronic inflammatory/autoimmune disorders

Miller, Gary, PhD , RSPH, Environmental Health - Environmental sciences, exposome

Morris, Alanna, PhD, Emory SOM, Medicine (Cardiology) - Social determinants of cv health, racial disparities, heart failure

Mulle, Jennifer, PhD, RSPH, Epidemiology - Mental health, genetics, genomics, microbiome

Narayan, Venkat, MD, MPH, RSPH, Global Health - Cardiometabolic disease epidemiology, diabetes, global health policy

Patzer, Rachel, PhD, Emory SOM, Surgery - Social determinants of health, minority health, health inequities, health services research, chronic kidney disease, epidemiology

Pemu, Priscilla, MD, Morehouse SOM - Social determinants of health, racial disparities, interventions and implementation sciences

Quyyumi, Arshed, MD, Emory SOM, Medicine (Cardiology) - Vascular biology, vascular function, cardiovascular health disparities

Searles, Charles, MD, Emory SOM, Medicine (Cardiology) - Vascular biology, molecular biology

Shah, Amit, MD, MSCR, RSPH, Epidemiology - Cardiovascular epidemiology, psychosocial factors, mind-body relations

Smith, Andrew, Emory SOM, Medicine (Cardiology) - Cardiovascular medicine, heart failure, clinical trials

Steenland, Kyle, PhD, RSPH, Environmental Health - Epidemiology research methods, environmental sciences, occupational health

Stein, Aryeh, PhD, RSPH, Global Health - Nutrition, global health, cardiovascular epidemiology, bioethics

Suglia, Shakira, PhD, RSPH, Epidemiology - Cardiovascular epidemiology, Latino health, health disparities, psychosocial factors, children/adolescent health

Sun, Yan, PhD, RSPH, Epidemiology - Genetics, epigenetics

Taylor, Herman, MD, Morehouse SOM - Social determinants of health, racial disparities, interventions and implementation sciences

Taylor, W Robert, MD, PhD, Emory SOM, Medicine (Cardiology) - Vascular biology, molecular biology

Vaccarino, Viola, MD, PhD, RSPH, Epidemiology - CVD epidemiology, women’s health, psychosocial factors

Waller, Lance, PhD, RSPH, Biostat+Bioinformatics - Biostatistics/bioinformatics, geospatial analysis

Wilson, Mark, PhD, Emory Yerkes Primates Center - Behavioral sciences, nonhuman primate models, neuroendocrinology, social stress

Wilson, Peter, MD, Emory SOM, Medicine (Cardiology) - Cardiometabolic epidemiology, genetics

Core training elements (both pre-doctoral and post-doctoral trainees)

  • Mentored research using a team mentoring approach;
  • Didactic coursework tailored to trainees’ interests and background;
  • Participation in bi-weekly multidisciplinary seminars and research in progress meetings;
  • Participation in yearly research in progress symposium;
  • Grant writing (NRSA F1/F2 or K award).

Additional training

  • Pre-doctoral trainees: three multidisciplinary rotations, original data collection leading to a publishable dissertation in the area of cardiovascular health inequalities
  • Post-doctoral trainees: individualized didactic training and rotations; opportunity to obtain a MS in Clinical Research  including a year of course work followed by a publishable research project (2-years)

Criteria for appointment to the training program will include academic potential, previous experience, research interest in cardiovascular health inequalities, and compatibility with existing mentors. Only U.S. citizens and permanent U.S. residents are eligible for this program. For details on the stipend support provided, visit the National Institutes of Health website.

Pre-doctoral Fellows:

Will be considered among those accepted in the RSPH’s PhD programs

Program covers tuition and stipend while in the fellowship program.

Post-doctoral Fellows:

MDs from various backgrounds pursuing a research career in cardiovascular disease, or PhD graduates in epidemiology, behavioral sciences, environmental sciences, health policy, or other relevant disciplines.  Program covers stipend for up to two years.

Postdoctoral applicants should include a statement of research interests and proposed goals for the fellowship; curriculum vitae; and three letters of recommendation.

Send applications or inquiries to:

Steven Harris, Program Administrator
Department of Epidemiology
Emory University Rollins School of Public Health
404-727-1020
steven.harris@emory.edu

Mental Stress-Induced Ischemia, Mechanisms and Prognosis (MIPS) (Contact: Arshed Quyyumi, Viola Vaccarino)

The overall objective of this program project grant is to generate novel data on the causal mechanisms of mental stress-induced myocardial ischemia (MSIMI), to identify vulnerable patient groups who are susceptible to MSIMI, and to determine the clinical importance of MSIMI in a diverse and contemporary patient population with stable coronary artery disease. Subprojects will assess brain imaging and vascular correlates of MSIMI to explore potential mechanisms underlying this phenomenon.

Mental Stress and Myocardial Ischemia after MI: Sex Differences and Mechanisms (MIMS2) (Contact: Viola Vaccarino)

The purpose of this ongoing project is to evaluate whether young women who have recently had a myocardial infarction (MI) are more susceptible to myocardial ischemia due to psychological stress relative to men of similar age; examine the mechanisms underlying ischemia due to psychological stress in women relative to men; and assess whether ischemia due to psychological stress is implicated in the worse prognosis of women with MI compared with men.

Post-traumatic Stress Disorder and Ischemic Heart Disease Progression (Contact: Viola Vaccarino)

The purpose of this ongoing project is to examine the longitudinal association between PTSD and ischemic heart disease by doing a follow up study of twins in the Vietnam Era Twin Registry 10 years after a baseline visit that involved assessments of ischemic heart disease with positron emission tomography (PET) myocardial perfusion imaging and other measures of cardiovascular risk.

Emory Twin Study (Contact: Viola Vaccarino)

The major goal of this project is to assess the role of possible mechanisms underlying the association of depression and posttraumatic stress disorder (PTSD) with cardiovascular disease using a twin design, and examining subclinical indicators of myocardial perfusion measured with positron emission tomography (PET), and biomarkers of immune and autonomic dysregulation. The data collection has been completed and data are available for specific analyses.

The Morehouse-Emory Cardiovascular (MECA) Center for Health Equity (Contact: Herman Taylor, Arshed Quyyumi)

The primary goals of the MECA collaborative are to: 1) identify psychological and social factors at the community and individual level that promote cardiovascular "resilience" among African-Americans in the metropolitan Atlanta area; and 2) identify the vascular and molecular correlations of resilience in this population pre- and post intervention.

Emory Cardiovascular Biobank (Contact: Arshed Quyyumi)

This prospective registry and biorepository was established to investigate the genetic basis of oxidative stress, vascular dysfunction, cardiovascular disease and stroke from patients undergoing cardiac catheterization at Emory University Hospital, Grady Memorial Hospital, and the Atlanta Veterans Administration Medical Center.  The Biobank contains over 5000 blood specimens that are stored for DNA, RNA, proteomics, metabolomics, and biomarker assays.  In addition subjects provide data regarding demographics, medications, alcohol/drug use, family history of cardiovascular disease, physical and emotional health status, sleep quality, and prior medical history. Subjects are followed annually for future adverse CVD events including deaths, MI, admissions of acute coronary syndromes or heart failure, revascularization, strokes and PAD events.

Emory-Morehouse Partnership to Reduce Cardiovascular Health Disparities (META-Health) (Contact: Arshed Quyyumi, Viola Vaccarino)

The META Health study is the result of a collaborative partnership between Morehouse School of Medicine and Emory University. The purpose was to characterize racial/ethnic differences in obesity-related cardiovascular disease (CVD) through interdisciplinary and inter-related projects. Of particular interest in characterizing racial/ethnic disparities are maladaptive behaviors (sedentarity lifestyle and unhealthy diet); social environment; psychological stressors; vascular dysfunction (arterial stiffness and endothelial dysfunction) and pathobiological pathways (inflammation, oxidative stress and insulin resistance).  The design was operated in two stages: (1) a random-digit-dialing of African-American and White residents of metropolitan Atlanta, aged 30-65 years, stratified by county median income and (2) a clinical visit at both institutions on a subset. The psychosocial factors were centered race-based discrimination, financial hardship and general stress. The measurements performed during the clinical visit included blood pressure, anthropometry (standards and bioimpedance), vascular function, salivary cortisol, blood and urine biomarkers. Specimens, as well as DNA, were stored for future studies. Data collection is completed and is available for specific analyses.

Biopsychosocial Risk Factors of Heart Failure Using mHealth Technologies (Contact: Amit Shah)

The goal of this project is to perform a comprehensive analysis of the risk factors for heart failure readmission, including psychological, social, and physiologic. We will integrate mobile health technologies to detect changes in environment and health status over time.

Closed-loop Vagal Nerve Stimulation in Patients with Traumatic Stress Exposure (Contact: J. D. Bremner, Amit Shah)

Vagal nerve stimulation is a therapy for treatment resistant depression, but its effect on PTSD is unknown. This is a study of the brain effects of transcutaneous vagal nerve stimulation (vs. sham), as well as a comprehensive analysis of its effects on the autonomic nervous and immune systems in subjects with history of traumatic stress exposure.

Atherosclerosis Risk in Communities (ARIC) Study (Contact: Alvaro Alonso)

The ARIC study is a prospective cohort that recruited 15,792 men and women from four communities in the US in 1987-1989. The main goal of the ARIC study is to understand the determinants of atherosclerosis and atherosclerotic diseases (such as heart attacks and stroke) in the general population. We are using data collected in the ARIC study to investigate the epidemiology and risk factors of atrial fibrillation.

Comparative effectiveness of non-vitamin K oral anticoagulants (NOACs) in atrial fibrillation (Contact: Alvaro Alonso)

Using two large administrative healthcare databases (MarketScan, from Truven Health Analytics, and Clinformatics, from Optum), we are studying the risks and benefits of different treatments used in patients with atrial fibrillation.

Power Up for 30 (PU30) Baseline Survey - Statewide physical activity survey (Contact: Julie Gazmararian)

Statewide survey of all (n=1,320) elementary schools in Georgia, conducted October 2013 - September 2014. Used to provide 1) state-wide baseline 2) schools personalized feedback during training; and 3) comparison for formative evaluation. Respondents from each school were administrators, lead classroom teacher from each grade level, and PE teacher. Data collected included information about before, during and afterschool physical activity (PA) time and integration, PA professional development and resource usage, staff engagement, staff wellness, and community and family engagement. Data linked to DOE demographic information. A survey in 2015 was conducted to assess impact of intervention.

Fitnessgram (Contact: Julie Gazmararian)

One component of statewide standardized fitness assessment conducted on all students. Respondents were all students grades 4-12 in all Georgia elementary schools. Extensive data were collected physical fitness, including general fitness, cardiovascular fitness, BMI and percent body fat.

HealthMPowers Nutrition Survey (Contact: Julie Gazmararian)

Conducted May 2015; developed to provide 1) baseline of Georgia SNAP-Ed elementary school wellness policies, nutrition practices and environments 2) schools personalized reports containing data and recommendations. Respondents from schools included administrators, grade level chairs, lunchroom/nutrition managers. Survey link sent to 86 Georgia SNAP-Ed elementary schools by HMP Health Educators. Data included baseline information about school wellness policies, nutrition practices and environments, and staff suggestions for improvement to encourage student consumption of healthier foods and beverages. Linked to DOE data, PU30 survey and fitnessgram.

Empowering Healthy Active Schools (Contact: Julie Gazmararian)

Physical activity (PA) intervention in elementary schools provided to 29 schools (and 7 control schools).

Respondents were 4,000 intervention students; 1,000 control students. Data are available at the student level (compared to PU30 surveys which are at school level), fitnessgram, PA in classroom, student PA levels, student behavior and knowledge, school climate survey. Data linked to DOE data (including individual level education outcome data – e.g., test scores).

The Boricua Youth Study (BYS) Cardiovascular Health Study (Contact: Shakira Suglia)

This study seeks to examine the role of childhood adversity on cardio-metabolic health among a cohort of Puerto Rican young adults living in the South Bronx, NY and the San Juan metro area, Puerto Rico. We furthermore seek to identify modifying factors, such as social support and positive coping among others that may buffer the effects of toxic stress on cardiometabolic health among young adults.

Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure (Contact: Yan Sun)

The goal of this study is to identify genomic and psychological components that can contribute to African American women and young children using an integrative genomic and epigenomic approach. Findings from our project can contribute to developing interventions, and thus promote health and prevent hypertension in children and their mothers who may have both genomic and psychological environmental risks.

Million Veterans Program (MVP) Genes and CVD Risk (Contact: Yan Sun)

As part of the MVP study, this project aims to identify genetic associations of common and rare variants with CVD risk factors such as cholesterols, triglycerides, body mass index, and CVD prevalence and incidence among 400,000 veterans.

Expectations of Discrimination and CVD risk in African-American Women (Contact:  Tené T. Lewis)

This project uses innovative methodologies from public health and psychology to determine whether, in what contexts, and how “expectations” of discrimination contribute to early CVD risk in a cohort of healthy African-American women over a 2-year follow up.  Early CVD risk is assessed via changes in carotid intima media thickening (IMT), a measure of atherosclerosis, and 48-hour ambulatory blood pressure (ABP), a measure of autonomic physiologic arousal and a potential mechanism linking expectations of racism to IMT.

Social Stressors and Atherosclerosis in African-American Women with Lupus (Contact: Tené T. Lewis)

This project is designed to examine the impact of social stressors (e.g. financial stress, discrimination, early adversity, inadequate social support) on two distinct inflammatory phenotypes (SLE-related vs. CVD-related) and atherosclerosis in African-American women with Systemic Lupus Erythematosus (SLE), relative to healthy African-American comparison women.