UofL medical students Paul Brown and Andrea Ballinger conducted a study to decrease health disparities for Black patients by helping educate physicians about potential barriers to an important heart health test as part of a summer research program.
Black patients have been shown to receive coronary artery calcium scoring (CAC) tests eight times less frequently than white patients. The test reveals whether people at moderate risk for developing heart disease have calcium deposits in their heart arteries and physicians should recommend preventative medications for them, such as statins.
This summer, second-year medical students Brown and Ballenger created a video and questionnaire to help physicians understand and overcome potential barriers Black patients have experienced in obtaining the CAC test. With the help of Dinesh Kalra, chief of cardiology, and other physicians in the UofL School of Medicine, the video and survey were sent to physicians in the UofL Department of Medicine and other UofL providers.
“It reminds physicians about when this preventive test should be ordered, much like screening for blood glucose, cholesterol or cancers. Hopefully after that, we will be able to show that the gap we were seeing in African Americans getting tested less often will be eliminated,” Kalra said.
The survey revealed that the study increased physicians’ confidence in CAC testing and understanding of its role in predicting the risk of future heart attacks. After providers watched the educational video and reviewed guidelines for the test, they reported a greater willingness to order the test and understanding of implicit bias in medicine, which may drive such disparities in health care between Blacks and whites. Kalra’s team hopes to apply these findings in other diseases affected by such disparities, such as heart failure or blood pressure control.
Brown and Ballinger worked on the study as part of the UofL cohort of the national Robert A. Winn Diversity in Clinical Trials: Clinical Investigator Pathway Program (Winn CIPP). Winn CIPP offers a six-week summer service-learning experience for medical students who are underrepresented in medicine and committed to a career path that addresses diversity, equity, and inclusion in clinical trial studies.
Brown and Ballinger both have a personal or family history of heart disease, so they understand the need for preventative care delivered through the calcium scoring test. They see this summer’s project as a chance to improve their research skills to benefit their future patients.
“As medical students, we don’t get a lot of instruction on research in our classes,” Brown said. “This program has provided a great opportunity for me to learn as much as I can about research and how to ask questions and how to think and how to analyze data.”
Ballinger believes her experience in Winn CIPP will help her increase trust in research among Black and other underrepresented patients.
“The community aspect of reaching back and providing education and offering education to the community and creating trust in clinical research in general is really important to us moving forward in our career,” Ballinger said.
Seven medical students participated in four mentored projects with Winn CIPP at UofL for 2024, five of whom are UofL students. UofL first hosted the Winn CIPP program in 2023 and is one of nine sites for 2024.
