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Population Health Sciences


Program Highlights

  • Careful mentor matching, individualized career development planning, and rigorous academic training necessary to ensure success as an independent and collaborative investigator 
  • Designed for students with an advanced degree and/or relevant clinical research experience, the program provides opportunities for students to be directly involved in research from the first day. 
  • Competency-based, transdisciplinary research training program focused on translating research into effective clinical practice and policy 
  • Rigorous training in theory, ethics, epidemiologic methods, biostatistics, health services research, outcome measurement, and behavioral science 
  • Train with the innovators in clinical and health services research 
  • Supportive educational environment 
  • Average time-to-degree of 4 years
  • Excellent track record of placing our graduates in competitive post-doctoral fellowships, faculty positions, and public and private research careers 

Program Objectives

The overarching objectives of our doctoral training program are:

  1. To deliver a transdisciplinary research training program focused on epidemiology, biostatistics, and health services research geared toward translating research into effective disease prevention programs, clinical practice and policy 
  2. To recruit pre-doctoral trainees resulting in a diverse trainee pool with respect to socio-demographic characteristics, clinical background, and disciplinary perspective 
  3. To provide trainees with individual mentoring, academic training, and technical skills necessary to ensure their success as independent investigators as well as contributors to team science 
  4. To provide “hands on” research experience that builds on the strengths of the current environment of linkages between UMass Chan Departments, Centers, and Institutes 


To achieve the objectives of the Biomedical Sciences PhD degree in the Population Health Sciences Program, students must gain competency in the following areas: 1) theory and context, 2) study design, 3) analysis, interpretation, and presentation of data, 4) ethics, 5) information and data acquisition and management, 6) measurement, 7) effective communication, 8) professionalism and 9) critical appraisal. Our proposed educational model not only provides formal instruction in each of the areas noted, but also integrates and reinforces these concepts throughout the curriculum.
Learn more about specific competencies

Students develop a curriculum tailored to meet their needs based on previous accomplishments, their research interests, and their educational goals. Students are required to successfully complete:

  • CTS605A (3 credits)
  • CTS602A Epidemiology (3 credits) 
  • CTS603A, CTS603B Biostatistics (8 credits)
  • CTS702 Ethics (2 credits)
  • CTS875 Proposal Development(3 credits)
  • 4 credits of theory (selected based on research interests)
  • 6 credits substantive electives (selected based on research interests)
  • 8 credits of methods electives (selected based on research interests)

View all Population Health Sciences course offerings

In addition to formal coursework, students complete research assistantships (~20 hours per week); participate in research methods seminars, journal club, research in progress meetings, and workshops; and must serve as a teaching assistant for a minimum of one term.

A comprehensive project is conducted in the summer between year 1 and 2. Written qualifying exams are conducted in January of year 2. Students then develop and defend their dissertation proposal (by summer of Year 2). Students then complete their dissertation research which takes the form of 3 publishable manuscripts.
Learn more about evaluation milestones



Kate Lapane headshotKate Lapane, PhD
Professor, Quantitative Health Sciences
Associate Dean of Population Health Sciences
email Dr. Lapane


Our faculty and students conduct science that makes a difference in several areas of excellence, including:


The “graying” of the population makes research into the determinants and effects of aging on health a priority. In collaboration with the Division of Geriatric Medicine and the Meyers Health Care Institute, both led by Jerry Gurwitz, MD, aging research initiatives at UMass Chan aim to promote health, prevent functional decline, and improve quality of life among older adults.

Kate Lapane, PhDJen Tjia MD, and Jerry Gurwitz MD conduct studies of older adults.

CPHR students involved in aging research include Camilla Pimentel, MPH, who evaluated analgesic medication patterns among U.S. nursing home residents with cancer, and Alexandra Hajduk, MPH, who examined cognitive status as a predictor of secondary preventive lifestyle change in patients with acute coronary syndrome.




Cardiovascular Disease

Cardiovascular disease is the #1 killer of Americans, and several faculty and students in the CPHR program are committed to finding ways to better diagnose and treat diseases like myocardial infarction and heart failure. Cardiovascular disease research is supported in CPHR program through collaboration with the Transitions, Risks and Actions in Coronary Events (TRACE-CORE) study, led by and the Department of Population and Quantitative Health Sciences.

Select faculty engaged in cardiovascular disease research include Catarina Kiefe, MD, PhD, PI of the TRACE-CORE study and Chair of the Department of Quantitative Health Sciences, who, examines outcomes in ischemic cardiovascular disease, and Robert Goldberg, PhD, a nationally recognized PI of several CVD surveillance studies such as the 3 three-decades-long Worcester Heart Attack Community Surveillance Study.

Dr. Goldberg mentored Han-Yang Chen, MS, who used TRACE-CORE data and data form the Worcester Heart Attack Study.

Health Disparities

Health disparities research targets health improvement in populations disproportionately affected by disease, injury and disability. Active collaborations with the Department of Population and Quantitative Health Sciences and the Department of Family Medicine and Community Health.

Select faculty members involved in health disparities research include Milagros Rosal, PhD, Sarah Forrester, PhD, and Jeroan Allison, MD, MScEpi.

Health Informatics and Implementation Science

We are committed to the Department’s mission: to advance science and improve population health. We pursue the discovery and dissemination of new knowledge in the fields of health informatics and implementation science. Our work focuses on clinical research informatics, consumer health informatics, public health informatics and the translation of evidence into practice. Our goal is to achieve sustained improvements in health outcomes.

Our research funding portfolio has included intramural grants and extramural grants from NIH, AHRQ, PCORI, VA QUERI, and others. Our faculty have affiliations with neighboring organizations, including the VA (Bedford and Central Western Mass), Worcester Polytechnic Institute, UMass Amherst School of Computer Science, and Boston University. 

Division researchers have expertise in:

  • Implementing and evaluating interventions that engage individuals, families, health organizations, and community stakeholders in promoting healthy behaviors --- ranging from pilot studies to randomized controlled trials.
  • Recruiting and retaining diverse and underserved populations, utilizing community-based strategies and social media.
  • Integrating and analyzing various data, such as from electronic health records, to answer questions in healthcare, improve clinical workflow, and influence policy.
  • Utilizing state-of-the-art methods including machine learning (deep learning) and natural language processing.
  • Investigating the use of mobile health technologies, including smartphone apps, text messaging, and wearable technologies.


Health Promotion & Disease Prevention

Health promotion and disease prevention research aims to enable people to increase control over their health and its determinants, and thereby improve their health. It explores the behavioral, social and environmental influences on health and develops interventions to minimize disease and maximize wellbeing. Active collaborations among the CPHR program and the Division of Preventive and Behavioral Medicine led by Stephenie Lemon, PhD, the Department of Family Medicine and Community Health, and the Worcester Country Prevention Research Center contribute to this effort.


Health Services Research

Health services research is a multidisciplinary field focused on the organization, financing, delivery and outcomes of health care. This research aims to support higher quality, more efficient and less expensive medical care to populations. Active interdisciplinary collaborations with the Department of Population and Quantitative Health Sciences and Meyers Health Care Institute .

Select faculty members involved in health services research include Arlene Ash, PhD, whose work focuses on how best to measure and improve the value of U.S. health care spending, and Matthew Alcusky, PhD, PharmD, MS, who analyzes treatment patterns and costs for mental illness and substance use disorders in underserved populations.

CPHR students involved in health services research include Lisa Lines, MPH, mentored by Arlene Ash, whose AHRQ-funded predictive modeling of emergency department visits may identify patients at risk of future emergency department use.


Faculty at UMass Chan Medical School are dedicated to advancing the health of pharmacoepidemiology, including such areas as drug utilization research, comparative effectiveness, and comparative safety. The International Society of Pharmacoepidemiology defines pharmacoepidemiology as “the science that applies epidemiologic approaches to studying the use, effectiveness, value and safety of pharmaceuticals”. Select faculty engaged in pharmacoepidemiology research include Anthony Nunes, PhD, Matthew Alcusky, PhD, PharmD, MS, Kate Lapane, PhD, and Jen Tjia, MD. MSCE.

View Affiliated Faculty



Inspired by parents, PhD candidate first in family to pursue higher ed

Clevanne Julce speaking in video

Clevanne Julce is focused on preconception mental health care and equipping people with mental health tools and resources before they become pregnant. Her ultimate goal is to become an independent investigator and design culturally responsive preventive interventions for historically underrepresented populations with mood and anxiety disorders.

Read full story and watch video

Melissa Goulding, Population Health Sciences ProgramMelissa Goulding Headshot

Melissa Goulding’s research interests include chronic disease prevention and health promotion in children with an emphasis on health equity. Goulding received a three-year grant from the National Heart, Lung and Blood Institute to fund her dissertation research into how pediatric blood pressure screening guidelines are being followed locally.

Learn more about Melissa Goulding


For more detailed information about our current students, including their previous educational and professional experience, please visit this page.

Emmanuella Asantewaa Asiedu Headshot

Emmanuella Asantewaa Asiedu, BS, MPH

Emmanuella is mentored by Sarah Forrester, PhD and Jennifer Tjia, MD, MSCE. Her research interests are in social epidemiology and health disparities, especially looking at how social structural factors impact chronic disease burden in marginalized communities and how we can use what we know/learn from research to help reduce these health disparities.

Esther Boama-Nyarko headshot

Esther Boama-Nyarko, BS, MPH

Esther is mentored by Nancy Byatt, DO, MS, MBA, and her primary research interests are under the umbrellas of health equity, mental health, and community-based research. 

Claire Branley Headshot

Claire Branley, BS

Claire is mentored by Stephenie Lemon, PhD and her research interests include prevention of chronic disease through nutrition and diet-related interventions, particularly through government programs such as SNAP and WIC.  

Nathaniel Glassy Headshot

Nathaniel Glassy, ALM, CCRC

Nathaniel is mentored by David A Smelson, PsyD. His research interests include understanding substance abuse and cooccurring mental health disorders, their impact across neurocognitive domains, relationship of cognitive rehabilitation to treatment outcomes, and research participation among underserved populations.  

Carly Herbert headshot

Carly Herbert, BA

Carly is mentored by Apurv Soni, MD, PhD. Her research interests include infectious disease epidemiology and biostatistical approaches for the evaluation of infectious disease diagnostics and therapeutics at the population level.

Clevanne Julce headshot

Clevanne Julce, BS, MPH

Clevanne is mentored by Nancy Byatt, DO, MS, MBA and her primary research focus seeks to use a mixed-methods approach to investigate the intersection between the use of technology, preconception care delivery, and the growing field of implementation science.

Heeyoon "Melissa" Jung headshot

Heeyoon "Melissa" Jung, BSN, MS

Melissa is is mentored by Kate Lapane, PhD. Her current research interest is analyzing large population datasets to assess the safety and effectiveness of medical interventions.

Hyein (Sarah) Lee Headshot

Hyein "Sarah" Lee

Hyein Sarah Lee is mentored by Apurv Soni, MD/PhD. Her research interests are in using digital tools and qualitative methods to understand mechanisms of suicidality, structural racism, and iatrogenic harm in mental healthcare. 

Mary Lee Headshot

Mary R. Lee, BS, MPH

Mary is mentored by Sarah Forrester, PhD, and has research interests in global health and preventing chronic diseases, health disparities, and disordered eating behaviors among vulnerable populations. 

Shiwei "Echo" Liang headshot

Shiwei "Echo" Liang, MA, MS

Echo is mentored by Matthew Alcusky, PhD, PharmD, MS and her research interest is in pharmacoepidemiology and health system including insurance claim data, prescription drug effectiveness, health intervention, as well as the development of healthcare system evaluation to promote health surveillance.

Pryce Michener headshot

Pryce Michener, BS, BA

Pryce is mentored by Peter Friedmann, MD, MPH, DFASAM, FACP and is interested in health disparities and social epidemiology research particularly in people who use drugs or are experiencing homelessness.

Syed Naqvi headshot

Syed Naqvi, BS

Syed, a PhD Candidate mentored by Anthony Nunes, PhD, conducts research on improving care quality, managing comorbidities, and addressing pressure ulcers among older adults in nursing homes. His dissertation concentrates on quantifying the impact of family involvement on quality of care, mental, and physical health outcomes in nursing homes. Syed's work contributes to the understanding of how family support affects healthcare for older adults.

Laël Nethania Ngangmeni headshot

Laël Nethania Ngangmeni, BA, MBS

Laël is mentored by Kristin Mattocks, PhD, MPH and her research interests include infant and maternal health, health disparities—especially with regards to race and religion, immigrant and refugee health, and mental health. 

Natalia Nielsen headshot

Natalia Nielsen, MPH

Natalia is mentored by Kate Lapane, PhD and Maira Castaneda Avila, PhD and has research interests in women’s health, aging, mixed methods research and working with minority populations.

Atinuke Oyinbo headshot

Atinuke Oyinbo, BSc, MPH

Atinuke is mentored by Mara Epstein, ScD, ScM and Kate Lapane, PhD and her research interests lie broadly in the field of cancer epidemiology, particularly in biomarkers, survivorship, comorbidities, polypharmacy and cancer disparities.

Meagan Sabatino headshot

Meagan Sabatino, BA, MSL

Meagan is mentored by Mathew Alcusky, PhD, PharmD, MS. and her research interests include the evaluation and implementation of innovative healthcare delivery strategies and comprehensive policy solutions that improve the healthcare system, patient outcomes, and access to care in underserved populations.

Gretchen Weaver headshot

Gretchen Weaver, BA, MPH

Gretchen is mentored by Apurv Soni, MD, PhD. She has research interests in global health, infectious diseases, language exchange, health equity, and mixed methods.

Peng "Billy" Zhou headshot

Peng "Billy" Zhou, MS

Billy is mentored by Chan Zhou, PhD and is currently interested in computational methods development of integrating multiple big data (high-throughput sequencing genomics, transcriptomics and clinical health record) to explore noncoding RNAs and epigenomics for personalized medicine.


Getting Results…
  • Transgender, gender-diverse patients face barriers to eating disorder care, UMass Chan survey finds

    Transgender, gender-diverse patients face barriers to eating disorder care, UMass Chan survey finds

    According to research by Katarina A. Ferrucci, PhD’23, transgender and gender-diverse people face more challenges than cisgender people in accessing treatment for eating disorders, and care providers aren’t always aware of the barriers.

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  • Inspired by parents, PhD candidate first in family to pursue higher ed

    Inspired by parents, PhD candidate first in family to pursue higher ed

    Clevanne Julce, MPH, remembers being obsessed with Band-Aids as a kid, but views her work in the Clinical and Population Health Research PhD program at UMass Chan as a more permanent cure.

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  • PREP graduates, IMSD scholars honored; learn social side of science

    PREP graduates, IMSD scholars honored; learn social side of science

    Students in the UMass Chan Medical School Postbaccalaureate Research Education Program and Initiative for Maximizing Student Development program were honored at a dinner, where they were also given tips on interacting in professional social settings.

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  • Melissa Goulding receives highly competitive NIH Kirschstein Award

    Melissa Goulding receives highly competitive NIH Kirschstein Award

    PhD candidate Melissa Goulding has received funding from the National Heart, Lung and Blood Institute to explore how clinical practice guidelines for blood pressure screening in children are being followed, identifying potential targets to improve pediatric preventive care.

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  • Next generation of VA researchers to explore maternal health during new summer research training program

    Next generation of VA researchers to explore maternal health during new summer research training program

    UMass Chan students Micaela Tobin and Laël Ngangmeni and two undergraduate students will conduct qualitative research focused on pregnancy and maternity care through a VA training program designed to diversify the research workforce. Kristin Mattocks, PhD, MPH, is the program director at UMass Chan.

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  • UMass Chan student trustee focused on diversity, equity and inclusion

    UMass Chan student trustee focused on diversity, equity and inclusion

    UMass Chan Medical School MD/PhD student Zach Dyer is serving as a student trustee on the University of Massachusetts Board of Trustees and is focused on diversity, equity and inclusion.

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  • Zachary Dyer - Ash Research Group - Funded by NIH

    Outlining Shadows of Structural Racism Using Publicly Available Social Determinants of Health Data

    Black, Latinx, and Indigenous populations in the US face a disproportionate burden of poor health outcomes. Progress toward eliminating gaps in health outcomes is minimal, despite increasing investments in and awareness of health inequities. Recognizing that those inequities are rooted in the conditions in which we live, grow, work, and learn, there has been increased attention toward social determinants of health. In the past several years, health systems and the federal government, through Medicare and Medicaid, have committed billions of dollars to address health-related social needs such as housing, nutrition, and transportation. Though increasingly recognized as the root cause of unequal mortality and disease burden, structural racism is infrequently considered, poorly understood, and inadequately measured. Using a structural racism framework, this study will create a neighborhood-level structural racism effect index by compositing publicly available data. Including data about housing, transportation, education, wealth and poverty, social cohesion, the built environment, employment, and criminal justice, the structural racism effect index will capture broad and interwoven effects of past and current racist policies. The index will assign a score of 0-100 to each census tract in the US and will be tested against publicly available outcome data such as average area life expectancy and prevalence of select health outcomes. The novel structural racism effect index may be used to predict costs and outcomes, direct resources, and inform decision-making about under-resourced populations. To illustrate the policy implications of a measure for the effects of structural racism, the index will be used to characterize the Medicaid population as a means of providing insight into where investments should be made. Using Massachusetts as a test case, this project will quantify the extent to which structural racism's effects modify the impact of a $149 million program to address the health-related social needs of the Massachusetts Medicaid population. 1

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  • Melissa Goulding, Lemon research group, funded by NIH

    Adherence to Clinical Practice Guidelines for Screening and Management of Pediatric High Blood Pressure within a Massachusetts Safety-Net Health Care System

    Cardiovascular trajectories begin in early childhood and continue across the life course. Early recognition and management of cardiovascular disease (CVD) risk factors in childhood stand to improve these trajectories and prevent CVD risk factors in adulthood. One CVD risk factor which in conjunction with obesity has gained prominence in childhood and which affects about 1 in every 25 children in the U.S is hypertension. Health disparities which are intrinsically linked to social determinants of health (i.e., the circumstances that children live in), persist in the prevalence of hypertension with consistently higher rates of this condition seen in those of lower socioeconomic status and those of Black race and Latino ethnicity. The American Academy of Pediatrics (AAP) 2017 Clinical Practice Guidelines recommend regular screening and follow-up for the detection and management of hypertension. However, diagnosis of this condition is rare (~74% undiagnosed), and there are racial disparities in the likelihood of diagnosis as white children are more likely to have this condition diagnosed. Understanding the processes that lead to a diagnosis of hypertension (e.g., blood pressure screening and follow-up), since the release of the updated AAP guidelines, is lacking. Therefore, the goal of the present investigation is to describe the current state of pediatric blood pressure screening and follow-up according to the 2017 AAP guidelines. Using retrospective electronic health record data for children aged 3-17 years from the UMass Memorial Health Care System, a safety-net system, and the largest non-for profit health care system in Central Massachusetts, we will: (1) conduct a one year period prevalence study to quantify the prevalence of guideline adherent blood pressure screening and examine disparities in lack of receipt of guideline concordant care; (2) conduct a cohort study through which we will describe the cumulative incidence of guideline adherent follow-up after the detection of high blood pressure and disparities in the lack of receipt of guideline concordant care; and (3) conduct a qualitative study through which we will describe providers’ experiences with and perceptions of clinical practice guidelines for pediatric blood pressure screening and follow-up. Through the present work it is hypothesized that inequities in care, heterogeneity in follow-up, and challenges to guideline adherence will be identified to inform future efforts to improve clinical practice guideline uptake and pediatric preventive care. Supported by a robust academic environment at the University of Massachusetts Medical School, and a rigorous, tailored training plan, this F31 will position Ms. Goulding to become an independent investigator addressing CVD health disparities among youth.

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    The Influence of Spatial Proximity to Sterile Syringe Sources and Secondary Syringe Exchange on HCV Risk Among Rural People Who Inject Drugs

    The current U.S. opioid epidemic has fueled an increase in injection drug use and, in turn, an alarming surge in new hepatitis C virus (HCV) infections. Between 2010 and 2015, the incidence of HCV increased by 294% nationally, driven primarily by a rise in injection drug use and risky injection behavior – namely syringe sharing. This growing epidemic has disproportionately affected young people who inject drugs (PWID) in rural communities. There is an urgent need to implement tailored and effective harm reduction strategies to rural PWID who are disproportionately impacted by HCV. Although research has shown that syringe services and pharmacy syringe sales (i.e sterile syringe sources) are associated with a reduction in injection-mediated risks and HIV transmission, the evidence for whether these services reduce HCV risk among PWID remains mixed. This proposal will applying the risk environment model to evaluate the influence of sterile syringe sources on the HCV risk environment. Specifically, this proposal will evaluate whether spatial proximity to sterile syringe sources and receptive secondary syringe exchange are associated with HCV serostatus among rural PWID. The aims are: (1) To evaluate the association between road network distance to the nearest sterile syringe source (SSP or pharmacy that sells nonprescription syringes) and HCV serostatus; (2) To use egocentric social network analysis to evaluate the association between receptive secondary syringe exchange and HCV serostatus; (3) to explore and unpack rural PWIDs’ perceptions of and experiences with syringe acquisition and syringe sharing practices through in-depth interviews. These findings could help inform the development of future harm reduction interventions in rural New England, a region of the country that has been particularly hard hit by the opioid epidemic and related HCV infections.

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  • Ariel Beccia, PHARE Study Group, Funding provided by National Institute on Minorty Health and Health Disparities

    Intersectionality of Sexual Orientation, Gender Expression, and Weight Status on Risk of Disordered Eating Behaviors

    A glaring sexual orientation-related disparity is in the prevalence of disordered eating behaviors (DEBs), including severe calorie restriction, self-induced vomiting, laxative and diet pill use, and binge-eating. One in three sexual minority young people (lesbian, gay, bisexual, and other non-heterosexual individuals) engage in DEBs, a seven-fold higher odds than their heterosexual peers. There are considerable health consequences associated with these behaviors, such as metabolic and reproductive health issues, substance use, depression, and suicidality. However, research on DEBs lags behind that on other sexual orientation-related health disparities, with critical gaps including failing to consider both within-group diversity in risk and the upstream social determinants of the observed disparities. Importantly, experiencing multiple forms of social disadvantage has been shown to increase risk of eating-related pathologies, including DEBs. Gender nonconforming and higher-weight (i.e., overweight/obese) statuses are especially relevant dimensions of disadvantage to consider, as these groups experience high levels of appearance-based discrimination and may use DEBs as dangerous body-modification practices to cope. Sexual minorities who experience further marginalization through membership in these groups may encounter unique and/or compounding social stressors that exacerbate risk. Examining the intersectionality of sexual orientation, gender expression, and weight status is thus critical to addressing these research gaps. Using the Growing Up Today Study (GUTS), a national longitudinal cohort study of over 27,000 participants (~20% of whom are sexual minorities), the aims of this proposal are to: 1) Quantify the intersectional effects of sexual orientation, gender expression, and weight status on risk of DEBs among young adults; 2) Quantify the effects of interpersonal-level determinants (bullying victimization, weight-based harassment) on risk of DEBs by sexual orientation, and evaluate differences by gender expression and/or weight-status; and 3) Quantify the effects of structural-level determinants (discriminatory social conditions, state policies) on risk of DEBs by sexual orientation, and evaluate differences by gender expression and/or weight-status. The National Academy of Medicine’s 2011 landmark report on sexual minority health stressed the importance of adopting an intersectional framework for disparities research to inform the development of inclusive health equity efforts. Applying this lens through leveraging novel statistical methods will further understanding of a critically understudied sexual minority health issue and help identify high-risk subgroups and modifiable contextual risk factors. A tailored training plan accompanies this proposal and outlines the steps required to advance the Applicant’s career as an independent researcher focused on intersectional health disparities research.

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    Feasibility of Smartwatches for Atrial Fibrillation Detection in Older Adults

    Atrial fibrillation (AF) is a cardiac rhythm abnormality that currently affects over 6 million Americans. This statistic is expected to double over the next decade given the increasing prevalence of AF risk factors such as advanced age and obesity. Atrial fibrillation confers a 5-fold risk of ischemic stroke, but can be treated effectively with anticoagulation therapy. Despite the efficacy of available treatment options, 1 in 5 patients with AF present with stroke as their initial manifestation of the arrhythmia. This is attributable to the significant challenge in diagnosing AF due to its episodic and sometimes asymptomatic nature. Existing AF monitoring strategies are burdensome or costly and invasive, and thus have low patient adherence and satisfaction. Recently, commercially available wrist-based wearable devices, or smartwatches, have shown to be accurate for AF detection, and may represent a promising tool for identifying AF. However, commercial devices are not primarily designed for use by older adults for arrhythmia detection, and there is a significant research gap in the feasibility of using smartwatches for arrhythmia detection in this population. Furthermore, no previous research has investigated the potential for implementation and integration of smartwatches into the healthcare system and infrastructure. Using data collected from the in-house randomized control trial Pulsewatch, and by conducting qualitative assessments in usability and implementation, this proposal addresses the evidence gap in the feasibility of smartwatches for AF detection with three specific aims: 1) to evaluate individual-level factors associated with adherence of using a smartwatch for AF detection, 2) to explore patient characteristics associated with acceptability of smartwatches and identify specific usability challenges and nuances for older adults, and3) to identify barriers and facilitators of implementing smartwatches for use in a clinical setting. We approach the problem with a user-centered focus and apply rigorous and systematic scientific methods in completing these aims. Knowledge generated from this proposal will provide future researchers and stakeholders with practical evidence in the potential use of smartwatches for detection of AF.

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  • Yiyang Yuan, MPH, MS, PHARE Study Group, Funding Provided by National Institutes of Health

    Concurrent trajectories of physical frailty and cognitive impairment among nursing home residents and community-dwelling older adults

    Physical frailty, characterized by decreased physiologic reserve and increased vulnerability to stressors, and cognitive impairment, ranging from mild impairment to dementia, often co-occur in older adults. Both are associated with considerable adverse health outcomes, high healthcare costs, and substantial caregiver burden, and are highly prevalent in U.S. community-dwelling older adults. However, for older adults receiving long-term care in nursing homes, data is scarce on the prevalence of the two conditions over their stay. Community-based studies suggest the heterogeneous clinical presentation of physical frailty, which may have implications for its management. It is unknown if such heterogeneity is similar in older nursing home residents and if it is influenced by cognitive impairment. Further, physical frailty and cognitive impairment share risk factors and predict the future onset of one another but the mechanism of this complex interplay remains unclear. Lastly, depression is strongly correlated with both conditions, yet findings regarding the impact of antidepressants on the progression of physical frailty and cognitive impairment are inconsistent. This proposed F99/K00 project seeks to address these gaps by two specific aims with population, longitudinal data, and advanced statistical methods. Aim 1 (dissertation research) focuses on older nursing home residents and will describe the prevalence of physical frailty and cognitive impairment; identify subgroups of physical frailty and examine the variation of subgroups by cognitive impairment levels, and delineate the developmental trajectories of physical frailty and cognitive impairment and examine the correlations between trajectories. Aim2 (post-doctoral research) expands to older adults in the community and will assess the reciprocal association between physical frailty and cognitive impairment; quantify the impact of cumulative exposure to antidepressants on trajectories of physical frailty, cognitive impairment, and depressive symptoms; and examine the effect of depressive symptoms as a mediator of physical frailty on cognitive impairment with causal mediation analysis. Methodological innovations include the use of latent class analysis, group-based trajectory models, structural equation models (autoregressive cross-lagged panel analysis; autoregressive latent trajectory model), and causal mediation. This proposal is directly relevant to the growing aging population in the U.S., including those residing in the nursing homes and those living in the community, since it uses the national nursing home database Minimum Data Set 3.0 (Aim 1) and the nationally representative Health and Retirement Study linked to Medicare Part D Drug Event Files and the Harmonized Cognitive Assessment Protocol (Aim 2). This project will shed light on the concurrent progression of age-related physical and cognitive conditions. Results will inform future work to develop diagnostic tools and prediction models to facilitate timely identification of older adults at risk for accelerated functional decline and implement care tailored to older adults’ needs to effectively delay the onset of negative health outcomes, enhance the quality of life, and foster healthy longevity.

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    Smoking Cessation in Persons with Mental Health Conditions: Exploring the Role of Family and Friends

    Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship to Promote Diversity in Health-Related Research (Parent F31-Diversity). Smokers with mental health conditions (MHC) have increased risk of dying from lung and cardiovascular disease. The smoking rate among people with MHC greatly exceeds the rate in the general adult population. Although, these smokers are interested in quitting, their quit rates are much lower than the general population. Factors that act as quitting barriers for these smokers, include pro-smoking social norms and attitudes/behaviors of social network members, underuse of pharmacotherapies and behavioral strategies, and inconsistent treatment of tobacco dependency of mental health providers. Thus, leading researchers have called for innovative approaches to address smoking disparities in people with MHC. Family/peer-based behavioral interventions can be an innovative and effective approach to target smokers with MHC for several reasons. Family/peers influence smoking behaviors, and their importance in health behavior change is well-established. Families/peers are often a principal resource for persons with MHC in seeking and accessing health services. A small but consistent body of literature suggests that family/peers may influence the cessation behavior of smokers with MHC. Family /peers could augment other cessation interventions such as adoption of pharmacotherapies. However, interventions that attempt to harness family/peer support for long-term smoking cessation have underperformed. Knowledge gaps exist in our understanding of the mechanisms through which family/peers affect smoking behaviors, as well as how to involve family/peers in smokers’ cessation efforts. Guided by the social influence domain, as outlined in the Theoretical Domains Framework, my dissertation will address these knowledge gaps. My specific aims are to: 1) prospectively examine the effect of family/peer influences on smoking cessation among smokers with MHC using data from the Population Assessment of Tobacco and Health (PATH study), a nationally representative survey of US non-institutionalized individuals in which participants are interviewed annually, 2) evaluate relationships between smokers’ characteristics, family/peer influences, and smoking cessation among smokers with MHC using Structural Equation Models, and 3) qualitatively explore social and clinical barriers and facilitators to smoking cessation and inclusion of family/peer support among smokers with MHC and mental health care providers. This work in combination with the proposed training will facilitate my development into an independent research scientist committed to conducting research focused on tobacco prevention and control. I will be supported by an outstanding mentoring team with expertise in all the relevant areas: smoking cessation, mental health, implementation science, and biostatistics. My research directly addresses NHLBI’s objective of better understanding the causes of population health differences and identifying strategies to effectively address these differences.

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  • Apurv Soni, Allison Research Group, Funded by NIH

    Trends, Predictors, and Consequences of Child Undernutrition

    One out of every three children under the age of five in India are undernourished (48 million); to address this crisis, Indian government established a national program from 2005-2012. This study will apply advanced geospatial and multilevel methods to investigate 1) the changes in child undernutrition in India from 2005 to 2012, 2) individual, household, and community level predictors of child undernutrition, and 3) consequences of undernutrition on development during pre-adolescent (8-11) years. Results from this study can guide effective policymaking and implementation of intervention programs.

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  • Lisa Nobel, Allison Research Group, Funded by NIH

    Patient and Social Determinants of Health Trajectories Following Coronary Events

    About 1.2 million Americans are hospitalized annually with acute coronary syndrome (ACS), and most are discharged alive. Although post-ACS mortality and clinical morbidity have been improving patients may be living longer but not better. In fact, many patients suffer substantial declines in quality of life and functional status after discharge with ACS. Because of critical gaps in our understanding how health status evolves over time for ACS patients, important opportunities for prevention and intervention are potentially being missed. The proposed research takes a systematic approach to examining the association of demographic, psychosocial, clinical, and neighborhood factors on trajectories of health-related quality of life after discharge for ACS. Our study will leverage the availability of rich data already collected for the NHLBI-funded TRACE- CORE, a longitudinal prospective cohort study of 2,183 patients hospitalized with ACS. This study includes data from interview, medical record abstraction, linked administrative databases, and geo-coded census tracks. Specific aims are to: (1) Determine associations between individual level socio-economic, clinical, in- hospital and psychosocial factors and trajectories of patient health status post-ACS discharge, both generic (SF-36) and disease specific (Seattle Angina Questionnaire with domains of physical limitations, angina stability, angina frequency, treatment satisfaction and angina specific quality of life); (2) Determine how neighborhood deprivation is associated with trajectories of patient health status; and (3) Identify the extent to which trajectories of generic quality of life and disease-specific quality of life at baseline, one month, 3 months and 6 months predict mortality or readmission 6 months to 1 year post-ACS discharge. This pre-doctoral fellowship proposal also includes a carefully training plan for me to become an independent physician scientist able to fully exploit the potential of patient-reported outcomes to improve the lives of patients with cardiovascular disease.

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  • Daniel Frendl, Ware Research Group, Funded by NIH

    Functional Health Predictors of Other Cause Mortality Risk in Prostate Cancer

    This proposal has two primary aims: (1) to improve the understanding of the association between patient- reported functional health, comorbidity, and sociodemographic factors and other cause mortality in older men newly diagnosed with prostate cancer; (2) to develop a prototype tool for calculating individualized risk of other cause mortality in this population. Prostate cancer is the most common non-cutaneous cancer in American men and primarily afflicts those age 65 and older. However, most men are diagnosed at early stages with tumors that most often have an indolent course. Guidelines recommend that patients only pursue aggressive treatment if they have >10 year overall life expectancy. Within 5 years of diagnosis, only 11% of American men die due to their prostate cancer, while the majority of patients diagnosed with prostate cancer die of other causes. While validated calculation tools have been developed for clinical use in predicting prostate cancer related mortality, no validated tool has been developed from existing models that identify variables associated with the risk of dying of other causes (OCM). As men in the U.S. live longer and the population above age 65 is rapidly growing, individualized predictions of life expectancy are necessary given the substantial heterogeneity in individual health status. Nearly three quarters of this aging population may have multiple comorbid conditions. Previous work has shown that decrements in patient-reported functional health may be more strongly associated with OCM than the presence of most individual comorbidities. These findings have promise for improving the approach to accounting for the impact of multiple conditions. This predoctoral research training proposal seeks funding to explore the generalizability of prior work demonstrating the association of patient-reported functional health and OCM. The proposed work will help to identify the variables most strongly associated with OCM in older men with prostate cancer, utilizing data from 4,510 subjects in the linked Surveillance Epidemiology and End Results- Medicare Health Outcomes Study (SEER-MHOS) database. This database contains detailed information on cancer characteristics, treatment, cause of death, baseline comorbidities, sociodemographic information, and functional health measures. This proposal will evaluate and improve upon the performance of other cause mortality prediction models through modern statistical techniques to assess predictive model performance. After identifying key predictors of OCM, we propose to develop a prototype clinical risk-calculation tool that estimates personalized risk of 10-year OCM, adapting validated techniques for developing risk calculators. This study will help to establish the utility of patient- reported functional health measures in improving the accuracy of OCM risk estimation in older men newly diagnosed with prostate cancer and will make progress towards a clinically useful OCM risk estimation tool. Completion of this work will help to better identify older patients who would most likely benefit from aggressive treatment vs. those who may not, as they may be more likely to die of other causes.

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2019 Graduate
Mentored by Catarina Kiefe, PhD, MD and Robert Goldberg, PhD

Division of Cardiovascular Medicine
Department of Internal Medicine
UMass Chan Medical School, Worcester, MA

Dissertation: Religiosity and Patient Activation and Health Outcomes among Hospital Survivors of an Acute Coronary Syndrome


2019 Graduate
Mentored by Kate Lapane, PhD

Division of Epidemiology
Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Anticoagulant Use, Safety, and Effectiveness for Ischemic Stroke Prevention in Nursing Home Residents with Atrial Fibrillation


2016 Graduate
Mentored by David Harlan, MD

Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Evaluating Acceptability, Feasibility and Efficacy of a Diabetes Care Support Program Facilitated by Cellular-Enabled Glucose Meters


2022 Graduate
Mentored by Kate Lapane, PhD

Boston Children's Hospital/Harvard Medical School, Boston, MA

Dissertation: The Social Epidemiology of Gender and Eating Disorders: Theoretical and Methodological Considerations 


2019 Graduate
Mentored by Sharina Person, PhD and Catarina Kiefe, PhD, MD

Gillings School of Public Health
University of North Carolina at Chapel Hill

Dissertation: Gendered Race, Interpersonal Discrimination, and Cardiovascular Disease Disparities: Application of the Emerging Identity Pathology Model


2009 Graduate
Mentored by Patricia Franklin, MD, MBA, MPH

Department of Arts and Sciences, Master of Public Health Program
Massachusetts College of Pharmacy and Health Sciences, Boston, MA

Dissertation: Injection Treatment for Lower Back Pain in Older Adults with Lumbar Spinal Stenosis


2021 Graduate
Mentored by Mara Epstein, ScD, ScM

Department of Population and Qualitative Health Science
UMass Chan Medical School, Worcester, MA

Dissertation: The Role of a Monoclonal Gammopathy of Undetermined Significance Diagnosis in Healthcare Utilization


2015 Graduate
Mentored by Robert Goldberg, PhD

University of Texas Health Science Center at Houston

Dissertation: Hospital Treatment Practices, 30-Day Hospital Readmissions, and Long-Term Prognosis in Patients Hospitalized with Acute Myocardial Infarction: A Dissertation


2023 Graduate
Mentored by Mathew Alcusky, PhD, PharmD, MS

Division of Pharmacoepidemiology and Pharmacoeconomics
Department of Medicine
Brigham and Women’s Hospital, Boston, MA

Dissertation: “ Improving Oral Anticoagulant Use among U.S. Nursing Home Residents with Atrial Fibrillation”.


2011 Graduate
Mentored by Becky Briesacher, PhD

Pfizer, Philadelphia, PA

Dissertation: Comparative Effectiveness of Alendronate and Risedronate on the Risk of Non-Vertebral Fractures in Older Women: An Instrumental Variables Approach


2012 Graduate
Mentored by Jeroan Allison, MD, MS

University of Delaware

Dissertation: Exploring the Psychosocial and Behavioral Determinants of Medication Adherence Among African Americans with Hypertension


2015 Graduate
Mentored by Eric Mick, ScD

Family Medicine and Community Health and Psychiatry
UMass Chan Medical School, Worcester MA

Leadership Education in Neurodevelopmental Disabilities Program and University Center for Excellence in Developmental Disabilities
E.K. Shriver Center
UMass Chan Medical School, Worcester MA

Dissertation: Attention Deficit/Hyperactivity Disorder, Screen Time, Physical Activity, and Diet Quality


2021 Graduate
Mentored by David McManus, MD

UMass Chan Medical School MD/PhD program

Dissertation: Feasibility of Smartwatch-based Atrial Fibrillation Detection Among Older Adults After Stroke


2008 Graduate
Mentored by Terry Field, PhD

US Food and Drug Administration’s Center for Food Safety and Applied Nutrition

National Center for Food Safety and Technology, Division of Food Processing Science and Technology

Dissertation: Bone Health and Coronary Heart Disease in Postmenopausal Women with Breast Cancer Treated with Tamoxifen 


2022 Graduate
Mentored by Arlene Ash, PhD

UMass Chan Medical School MD/PhD program

Dissertation: The Structural Racism Effect Index: a multi-dimensional tool to measure neighborhood-level structural racism


2019 Graduate
Mentored by Catarina Kiefe, PhD, MD and Robert Goldberg, PhD

University of North Carolina at Chapel Hill School of Medicine

Dissertation: Barriers to Healthcare Access and Patient Outcomes after a Hospitalization for an Acute Coronary Syndrome and other Acute Conditions


2023 Graduate
Mentored by William Jesdale, PhD

IPSOS (North America), Cincinnati, OH

Dissertation: Eating Disorders Among Gender Minority Individuals: Prevalence, Facilitators and Barriers to Care, and Pathways to Gender Competency Among Mental Health Providers


2011 Graduate
Mentored by Lori Pbert, PhD

Medical University of South Carolina, Charleston, SC

Dissertation: The Effect of Glycemic Index and Glycemic Load on Glucose Control, Lipid Profiles and Anthropometrics among Low-Income Latinos with Type 2 Diabetes


2023 Graduate
Mentored by Stephenie Lemon, PhD

Division of Preventive and Behavioral Medicine
Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Adherence to Clinical Practice Guidelines for Screening and Management of Pediatric High Blood Pressure: A Mixed Methods Study


2014 Graduate
Mentored by Jane Saczynski, PhD

Yale University School of Medicine, New Haven, CT

Dissertation: Cognitive Status and Initiation of Lifestyle Changes Following Acute Coronary Syndrome


2022 Graduate
Mentored by Kate Lapane, PhD

UMass Chan Medical School MD/PhD program

Dissertation: Healthcare Utilization in Youth with Mental Health Conditions


2019 Graduate
Mentored by Kristin Mattocks, PhD, MPH

VA Central Western Massachusetts Healthcare System, Leeds, MA

Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Understanding the Experience and Evaluating the Occurrence of Depression in a Sample of Pregnant Veterans


2021 Graduate
Mentored by Arlene Ash, PhD

Dialysis Clinic, Inc., Nashville, TN

Dissertation: Assessing and Modeling Quality Measures for Healthcare Systems


2014 Graduate
Mentored by Arlene Ash, PhD

RTI International, Waltham, MA

Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Outpatient Emergency Department Utilization: Measurement and Prediction


2017 Graduate
Mentored by Kate Lapane, PhD

Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester MA

Dissertation: Impact of Intra-Articular Injection Use on Patient-Reported Outcomes Among Patients with Knee Osteoarthritis


2019 Graduate
Mentor: Milagros Rosal, PhD

Rollins School of Public Health
Emory University, Atlanta, GA

Dissertation: Physiological and psychological stressors associated with glucose metabolism in the Boston Puerto Rican Health Study


2020 Graduate
Mentored by Kate Lapane, PhD

Division of Epidemiology
Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Statin Pharmacotherapy in US Nursing Homes


2021 Graduate
Mentored by Nancy Byatt, DO, MS, MBA

UMass Chan Medical School MD/PhD Program

Dissertation: Bipolar Disorder in the Perinatal Period: Understanding Gaps in Care to Improve Access and Patient Outcomes


2022 Graduate
Mentored by Rajani Sadasivam, PhD

Department of Population and Quantitative Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Smoking Cessation in People with Mental Health Conditions: Exploring the Role of Family and Peers


2023 Graduate
Mentored by Kate Lapane, PhD

Global Medical Epidemiology
Pfizer, Cambridge, MA

Dissertation: "Descriptive Epidemiology of Chronic Obstructive Pulmonary Disease In US Nursing Home Residents with Heart Failure"


2015 Graduate
Mentored by Kate Lapane, PhD

Department of Veterans Affairs, Veterans Health Administration
Bedford VA Medical Center, Bedford, MA

Dissertation: Use of Opioids for Pain Management in Nursing Homes


2012 Graduate
Mentored by Lawrence Madoff, MD

Ontrak, Santa Monica, CA

Dissertation: A Population-Based Epidemiological Description of Socio-Demographic Characteristics and Predictors of Severity Among Hospitalized H1N1 Cases in Massachusetts


2014 Graduate
Mentored by George Reed, PhD

Epidemiology & Public Health
University of Maryland School of Medicine, Baltimore, MD

Dissertation: Depression in Rheumatoid Arthritis and an Estimation of the Bi-Directional Association of Depression and Disease Burden


2022 Graduate
Mentored by Shao-Hsien Liu, PhD

Value & Access by PPD, part of Thermo Fisher Scientific, Bethesda, MD

Dissertation: Prescribed Medications and Healthcare Resource Utilization in Reproductive-Age Women and Men with Rheumatic Disease


2021 Graduate
Mentored by Jeroan Allison, MD, MS

Program in Digital Medicine
UMass Chan Medical School, Worcester, MA

Dissertation: Trends, Predictors, and Consequences of child undernutrition in India


2020 Graduate
Mentored by Stephenie Lemon, PhD

Applied Research and Evaluation Branch
Division for Heart Disease and Stroke Prevention
Centers for Disease Control and Prevention, Atlanta, GA

Dissertation: A Mixed Methods Study of Local Policy, Systems, and Environmental Approaches Supportive of Healthy Eating and Physical Activity


2015 graduate
Mentored by Kate Lapane, PhD

Neuroscience, Global Evidence Outcomes

Dissertation: Latent Variable Approaches for Understanding Heterogeneity in Depression: A Dissertation


2013 Graduate
Mentored by Joseph DiFranza, MD

Office of Statistics and Evaluation
Massachusetts Department of Public Health, Boston, MA

Dissertation: Developing Three New Pathophysiologically Based Measures of Nicotine Dependence: A Dissertation


2015 Graduate
Mentored by Jean Frazier, MD

Department of Epidemiology
University of North Carolina at Chapel Hill

Dissertation: Causal Inference Methods for Assessing Neurodevelopment in Children Following Prenatal Exposure to Triptan Medications


2015 Graduate
Mentored by Molly Waring, PhD

Global Medical Epidemiology
Pfizer, Cambridge, MA

Dissertation: Diet Quality and Evening Snacking In Relation To Sleep Duration And Quality Among Women With Young Children


2022 Graduate
Mentored by Kate Lapane, PhD

Department of Quantitative and Health Sciences
UMass Chan Medical School, Worcester, MA

Dissertation: Physical Frailty and Cognitive Impairment in Older U.S. Nursing Home Residents


2022 Graduate
Mentored by Kate Lapane, PhD

Real World Solutions, Global Epidemiology & Outcomes Research
IQVIA, Cambridge, MA

Dissertation: The Use of Gabapentinoids for Pain in the Ongoing US Opioid Epidemic: A Study Using Real-World Data