Investigator Spotlight

5 Questions for Researchers

1. Why is your area of science important?
Among my primary areas of focus is Black maternal health equity. With respect to Black maternal health equity, while the rates of differential negative outcomes are well understood in the field, causes of and interventions to improve birth equity for Black birthing populations are not well understood. As a Black maternal health researcher and qualitative methodologist, I aim to elevate and center the voices of Black birthing populations and the community that surrounds them to develop an effective prioritized health research agenda and culturally responsive interventions to improve Black maternal health equity.

2. What was important in your Health Services Research training?
With respect to health services research and increasing health equity, I believe my training as a qualitative methodologist is paramount to my work as a researcher. I firmly believe that the implementation of rigorous qualitative methods has the potential to meaningfully enrich scientific evidence by capturing the realities of human experience in a way that is difficult to effectively measure or understand quantitatively. I aim to contribute to the field’s use of rigorous methods through my own research and by providing support to researchers across disciplines to effectively use qualitative research to improve health care and health equity.

3. What are the major take-home messages your current research provides?

My research sends the message that intentional engagement with Black women and communities in the planning and development of research agendas can advance patient-centered maternal health outcomes research that is patient engaged, sustainable, and inclusive. 

4. What are your goals or areas for future research?
Currently, my goals are my work related to Black maternal health equity is to first, work with members of the Denver community to develop a prioritized health research agenda to drive the direction of the Black maternal health research in Denver. I am also excited at the prospect of employing a variety of qualitative methods, such as conversation analysis, in new ways to support effective patient-provider communication as related to Black maternal and infant health.

5. What advice do you have for researchers who want to work in this area? OR What is the most important advice you have received from your mentors?
The most important advice that I’ve received from mentors is to listen and engage. I believe that some of the most meaningful contributions to science lie in the experiences and the perspectives of the community you are aiming to serve. If we listen and engage, and incorporate what individuals and communities are telling us we can more effectively work toward health equity.

Dr. Amy Feldman is an Associate Professor in the Section of Pediatric Gastroenterology, Hepatology, and Nutrition at the University of Colorado and is the Program Director of the Pediatric Advanced Hepatology and Liver Transplant Fellowship at Children’s Hospital Colorado. Dr. Feldman earned her medical degree from the University of Pennsylvania. She completed her pediatric residency and Chief Resident year at the Children’s Hospital of Philadelphia, her pediatric gastroenterology and hepatology fellowship at Children's Hospital Colorado, and an advanced fellowship in liver transplantation at Lurie Children’s Hospital in Chicago.  She also received a Master’s of Science in Clinical Science at the University of Colorado.  Her clinical interests include the management of children with liver disorders including those who require liver transplantation. Her research focuses on immunizations and vaccine-preventable infections in the pediatric solid organ transplant population. She is currently funded by an AHRQ K08 Career Development Award focused on improving immunization rates in the transplant population through the use of a mobile health app.

1. Why is your area of science important?

Pediatric solid organ transplantation has transformed the survival rate and quality of life for patients with organ dysfunction and failure. In the last decade, advancements in organ procurement, surgical and anesthetic techniques, and postoperative management have drastically improved short-term survival. However, infectious complications remain a major source of morbidity and mortality for transplant recipients. My work focuses on improving immunization rates to decrease post-transplant infections and improve the long-term survival of transplant recipients. 

2. What was important in your Health Services Research training?
The Surgical/subspecialists Clinical Outcomes Research (SCORE) Fellowship was absolutely pivotal to helping me get my research career off the ground. The SCORE fellowship not only included didactic training about health services research but also provided mentorship from a senior ACCORDS faculty mentor (Dr. Kempe), research guidance and support from statisticians and analysts, and weekly work-in-progress sessions to further develop my research ideas.  The CCTSI KL2 Program then provided additional time, funding, and mentorship which allowed me to collect critical pilot data for my K08 grant application.  I am now participating in the University of Colorado CCTSI Clinical Science PhD Program where I am receiving advanced training in clinical investigation and health outcomes research.

3. What are the major take-home messages your current research provides?

One in six pediatric solid organ transplant recipients is hospitalized with a vaccine-preventable infection (VPI) in the first five years post-transplant. These VPIs result in significant morbidity, mortality, graft loss, and increased hospitalization costs. Although immunizations are a minimally invasive and cost-effective approach to reducing VPIs, the majority of solid organ transplant recipients are not up to date on immunizations at the time of transplant.  Transplant recipients have lower rates of immunization for each of the major standard childhood vaccines than their healthy counterparts.  Qualitative research by our team has identified the following barriers to pre-transplant immunization:  (1) lack of knowledge about vaccine safety, efficacy, and timing in the pre-transplant period, (2) lack of communication and follow up about vaccines between multi-disciplinary team members, (3) lack of an easily accessible central vaccine record and (4) subspecialty clinic serving as the medical home but unable to deliver all necessary vaccines.  A transplant-specific immunization mobile-health app can potentially overcome these obstacles by providing transplant-specific vaccine education, housing a central vaccine record, providing a chat feature to enhance communication between parents and providers, and providing automated reminders when vaccines are overdue.

4. What are your goals or areas for future research?

My long-term goal is to improve short and long-term outcomes for pediatric transplant recipients, specifically by focusing on immunization practices.  Following my K08 award, I plan to conduct a multi-centered pragmatic trial of the Immunize PediatricTransplant mobile health app to evaluate the tool’s effectiveness in increasing immunization rates and decreasing post-transplant VPIs in pediatric solid organ transplant recipients nationally. If effective, this app could eventually be adapted for use in all children requiring complex chronic multidisciplinary care.  Additionally, I am co-leading a national network of 25 centers to collect data on the safety, immunogenicity, and clinical effeteness of live vaccines after transplant.  

5. What advice do you have for researchers who want to work in this area? 

My advice for those developing a research career:

1. Pick an area you are truly passionate about and let clinical questions drive your research
2. Have a wide variety of mentors that each brings unique expertise to your team
3. Know that it will take many attempts and re-attempts for each manuscript and grant that is ultimately successful- do not give up!