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Principal Investigator: CORINNA GEHRETT LEVINE
Organization: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
Fiscal Year: 2024
Award: $154,440
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT SUMMARY/ ABSTRACT
Goal: This proposal provides a structured research training program under the guidance of mentors and advisors
in related fields to promote Dr. Levine’s development into an independent clinician-scientist. Her long-term goal
is leading a multidisciplinary research teams to develop patient-centered treatment pathways and interventions
that improve outcomes and mitigate disparities in eosinophilic mucin chronic rhinosinusitis.
Research: Chronic rhinosinusitis is a debilitating disease of the paranasal sinuses that affects up to 16% of the
United States (US) population, causing intractable congestion, smell loss, and persistent headaches that can
lead to permeant and life-threatening morbidities. Research in diverse populations demonstrates that Hispanic
and Black patients are more likely to have severe chronic rhinosinusitis disease subtypes such as eosinophilic
mucin chronic rhinosinusitis (EMRS), a subtype common in the southern US. Hispanic and Black EMRS patients
present with more advanced disease, have worse post-treatment outcomes, and have high rates of morbidity
including facial bone deformities and vision changes. The etiology behind the disparities in EMRS presentation
and outcomes are unknown. Fundamental questions about how to reduce disease burden cannot be answered
until we understand the factors that influence EMRS treatment outcomes. The goal of this proposal is generating
evidence to predict EMRS treatment outcomes and reduce health disparities. We will employ a prospective
longitudinal cohort study and use semi-structured interviews of patients and providers to identify important EMRS
treatment outcome determining factors. The central hypothesis of this proposal is that EMRS disparities result
from the interplay of individual- and community-level health determinants and environmental exposures that have
quantifiable impacts on EMRS clinical and biological outcome measures. To test this, we will: 1) develop a
computation model integrating multi-level factors to predict EMRS post-surgical outcomes; 2) determine best-
practices to facilitate efficient and effective clinician-patient communication and EMRS care; 3) develop a pilot
intervention to reduce delays in care. We will engage stakeholders in pilot intervention development and
feedback. The proposed research aligns with the NIMHD mission to develop new research methods to improve
minority health and reduce health disparities. The research results will help inform clinical practice and treatment
recommendations to improve the quality of EMRS care and reduce disparities.
Training: To accomplish these aims Dr. Levine will receive mentorship, focused didactics, one-on-one tutorials,
and hands-on training in team science and mixed methods research, incorporating important aspects of
computational modeling and qualitative research. She will establish a robust rhinology research network to
facilitate a pathway to independence. A NIMHD K23 award will provide Dr. Levine with the protected time and
essential training to achieve her career goals of improving outcomes and reducing disparities for EMRS patients.
Terms: <ANOVA><Access to Care><Accessory Sinuses><Acculturation><Address><Affect><After Care><After-Treatment><Aftercare><Allergic><Analysis of Variance><Anatomic Abnormality><Anatomical Abnormality><Anosmia><Biological><Black><Black race><Caring><Causality><Cephalalgia><Cephalgia><Cephalodynia><Clinical><Clinical Treatment><Communication><Communities><Computer Models><Computerized Models><Cranial Pain><Cultural Assimilation><Data><Decrease disparity><Decrease health disparities><Deformity><Development><Dimensions><Disease><Disorder><Disparities><Disparity><Early treatment><Education for Intervention><Educational Intervention><Environmental Exposure><Environmental Factor><Environmental Risk Factor><Ethnic Origin><Ethnicity><Etiology><Face><Facial Bones><Feedback><Filamentous Fungi><Florida><Future><Glean><Goals><Head Pain><Headache><Health Services Accessibility><Health disparity mitigation><Health disparity reduction><Hispanic><Home><Humidity><IgE><Immunoglobulin E><Impairment><Individual><Infection><Inflammatory><Inflammatory Response><Instruction Intervention><Interdisciplinary Research><Interdisciplinary Study><Intervention><Intervention Strategies><Interview><Investigators><K23 Award><K23 Mechanism><K23 Program><Knowledge><Language><Lead><Life><Long-term cohort study><Longitudinal cohort study><Longterm cohort study><Lower disparity><Lower health disparities><Lung><Lung Respiratory System><Measures><Mediating><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentors><Mentorship><Methods><Minority><Mission><Mitigate health disparities><Modeling><Molds><Morbidity><Morbidity - disease rate><Mucins><Mucous body substance><Mucus><Mucus Glycoprotein><Multidisciplinary Collaboration><Multidisciplinary Research><NCMHD><NIMHD><Nasal Sinuses><Nasal cavity/Paranasal><Nasal cavity/Paranasal sinuses><National Center on Minority Health and Health Disparities><National Institute of Minority Health and Health Disparities><National Institute on Minority Health and Health Disparities><Neighborhoods><Operative Procedures><Operative Surgical Procedures><Outcome><Outcome Measure><Paranasal Sinus Diseases><Paranasal Sinus Disorder><Paranasal Sinuses><Pathway interactions><Patients><Pb element><Physical environment><Polyps><Population><Population Heterogeneity><Position><Positioning Attribute><Predictive Factor><Prospective cohort><Provider><Qualitative Research><Race><Races><Recommendation><Recurrence><Recurrent><Reduce health disparities><Reporting><Research><Research Methodology><Research Methods><Research Personnel><Research Training><Researchers><Sampling><Science><Scientist><Severity of illness><Sight><Sinus><Socio-economic status><Socioeconomic Status><Structure><Surgical><Surgical Interventions><Surgical Procedure><Symptoms><Testing><Thick><Thickness><Time><Training><Training Intervention><Training Programs><Treatment outcome><United States><Variance Analyses><Vision><access to health care><access to health services><access to healthcare><access to services><access to treatment><accessibility of health care><accessibility to health care><accessibility to health services><accessibility to healthcare><advanced disease><advanced illness><anosphrasia><availability of services><biologic><black patient><burden of disease><burden of illness><care access><career><causation><chronic rhinosinusitis><clinical practice><cohort><community factor><community-level factor><computational modeling><computational models><computer based models><computerized modeling><cytokine><develop therapy><developmental><disease burden><disease causation><disease severity><disease subgroups><disease subtype><disorder subtype><disparate effect><disparate impact><disparate result><disparity reduction><diverse populations><early therapy><education resources><educational resources><environmental risk><face bone structure><faces><facial><head ache><health care access><health care availability><health care service access><health care service availability><health determinants><health service access><health services availability><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><heavy metal Pb><heavy metal lead><heterogeneous population><high risk group><high risk individual><high risk people><high risk population><homes><improve minority health><improved><improved outcome><improvement of minority health><inequitable effect><inequitable impact><inequitable outcome><instructional intervention><intervention development><interventional strategy><loss of smell><low SES><low socio-economic position><low socio-economic status><low socioeconomic position><low socioeconomic status><machine learning based model><machine learning model><measurable outcome><microbiome><mitigate disparity><mucous><olfactory loss><ossa faciei><outcome disparities><outcome inequality><outcome inequity><outcome measurement><pathway><patient centered><patient oriented><patient-clinician communication><patient-doctor communication><patient-provider communication><population diversity><post treatment><prevent><preventing><prospective><pulmonary><racial><racial background><racial origin><random forest><reduce disparity><reduction in disparity><research and methods><response><service availability><social cohesion><social culture><social stress><socially stressed><socio-cultural><socio-demographics><socio-economic position><sociocultural><sociodemographics><socioeconomic position><surgery><therapy development><tool><treatment access><treatment center><treatment development><trial regimen><trial treatment><unequal effect><unequal impact><unequal outcome><visual function>