Associate Professor Vice Chair of Research Services, Department of Epidemiology and Public Health Director of Clinical and Translational Research Informatics Center, University of Maryland School of Medicine Director of Research, Maryland Center of Excellence on Problem Gambling, University of Maryland School of Medicine Associate Director, Center for Healthcare Informatics and Bioimaging, University of Maryland Baltimore
Howard Hall, 102D
1992 Bachelor of Arts, University of Kentucky, Major: Psychology
2001 Master of Arts, University of Maryland Baltimore County
2003 Doctor of Philosophy, University of Maryland Baltimore County; Academic Specialization: clinical psychology, behavioral medicine
My contributions to science have focused on two major areas, women’s health and informatics methods to support multi-disciplinary team science.
In the area of women’s health I have cultivated a programmatic line of research focused on cervical cancer prevention in under-served groups of women. Through this work, my scholarship has helped advance our understanding of barriers to cervical cancer screening in sexual minority women (i.e., lesbians) and provided an evidence base for the design of interventions to increase screening among sexual minority women. Using electronic health record data, a graduate student and I were also able to successfully document disparities in HPV vaccination adherence among women and young girls receiving care at the University of Maryland Medical Center that highlighted significant disparities in adherence for minority women and girls compared to white women and girls. Characterizing this disparity highlighted the importance of developing strategies to foster increased adherence among young African American women and girls.
Through an ongoing collaboration with colleagues at a School of Medicine-affiliated Center for Vaccine Development (CVD) in Bamako, Mali, my team and I have successfully demonstrated that there are regional, geographic variations in high-risk HPV (the cause of cervical cancer) that must be characterized in order to adequately plan and predict the probable impact of HPV vaccination programs in sub-Saharan Africa and quite likely other regions worldwide. Our studies of the basic epidemiology of HPV in Mali formed the basis of data-driven mathematical models of HPV vaccination in Mali. These studies formed the basis of a successful application to the Gardasil Access Program (GAP) that allowed us to vaccinate more than 10,000 girls between the ages of 9-13 in Mali. Our successful implementation of the GAP project brought much needed vaccination to two districts in the capital of Bamako and achieved greater than 80% coverage for all 3 doses. We anticipate that the long-term impact of this project will be a significant reduction in new cervical cancer cases in these two districts over the next 20 years. Beyond the public health benefit of this research to the individuals vaccinated as part of this project, our success in delivering all 3 doses to more than 80% of vaccines provided the necessary data to qualify Mali for approval to add the HPV vaccine to the country’s Expanded Programme on Immunization (EPI) with support from GAVI, the Vaccine Alliance. Scaling of HPV vaccination country-wide under EPI and GAVI has the potential to substantially reduce cervical cancer mortality in Mali from 35/100,000 to approximately 10.5/100,000 over the next 20-30 years.
Informatics methods are often overlooked as strategies to more effectively and efficiently execute all aspects of research. Further, informatics can be a valuable tool for delivering evidence-based interventions to improve patient outcomes across a range of health indicators and conditions. As part of multidisciplinary teams, I have used my informatics expertise to design and implement strategies to accelerate recruitment, enhance retention in longitudinal studies, improve data quality and completeness, and expand the diversity of data sources that can be integrated to achieve the scientific aims of various research projects in both US and international settings. These strategies have been crucial to the success of federally funded projects in interstitial cystitis, understanding the human health effects of chronic domoic acid exposure, and a randomized controlled trial of telemedicine to improve outcomes in inflammatory bowel disease among others. Internationally, I have served as a key informatics consultant to build capacities for in-country informatics support at the University of Maryland’s Center for Vaccine Development in Mali. Capacity building efforts led to the formation of a core informatics unit at the field site that provides comprehensive informatics support for a large portfolio of vaccine trials and population-based studies, one of the largest of which was a multi-site study of diarrheal disease in children funded by the Gates Foundation. Over a period of approximately 2 years, I facilitate hiring and training of in-country personnel that were able to transition informatics support from US collaborators to full management in country with US collaborators serving in an advisory capacity.
women's health, disparities, cervical cancer, population health
Complete List of Published Work in My Bibliography: