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Summary of Research Mission


Mission:  To improve health through innovative research and collaboration.

Vision:  To be a nationally recognized partner in primary care research.

Values:  Patient-centered, Inclusive, Engaging, Relevant, Rigorous

The Family Medicine Research team’s areas of expertise include interventions such as shared decision making to improve disparities in patient outcomes, clinical trials with impact to address health disparities, implementation science, population health and informatics, and social determinants of health.  We also provide research and scholarship opportunities to residents, medical school students and other learners who are interested in primary care research or public health.

The Family Medicine Research Team can be reached at 704-304-7100 or at:
Mercy Medical Plaza
2001 Vail Avenue, Suite 400B
Charlotte, NC 28207



 Research Team

Hazel Tapp


Hazel Tapp, PhD
Research Director

Dr. Tapp currently serves as Director of Research in the Department of Family Medicine at Atrium Health, at the Center for Primary Care Research. Her research interests are broadly centered in improving health disparities and increasing health equity. This includes implementing improved delivery of care for patients with chronic diseases such as sickle cell disease, HIV, hepatitis C, diabetes, and asthma. As co-director of a practice-based research network (PBRN), the Mecklenburg Area Partnership for Primary Care Research, she works on several projects designed to use community based participatory research (CBPR) and implementation research to study improved outcomes for populations with chronic disease through implementation of evidence-based interventions. As PI on a PCORI patient-centered outcomes research institute project designed to study the dissemination of shared decision making using participatory implementation strategies, Dr. Tapp worked with 4 Practice-based research networks and Medicaid across North Carolina to implement shared decision making for asthma patients across 30 practices and in the Emergency Department. Also, in partnership with community members, patients, community organizational representatives, providers, and other research team members, Dr. Tapp helped develop and actively serve as a participating member of several community advisory boards (CABs) and patient advisory board (PAB). Dr Tapp is nationally involved in primary care research leadership, serving as Chair and Board Member of the North American Primary Care Research Group (NAPCRG) Program Committee. NAPCRG’s annual conference is attended by over 1200 primary care researchers from around the world and is considered the leading global General Practitioner and Family Medicine research conference. During the COVID-19 pandemic Dr Tapp is organizing a stakeholder advisory group for community outreach and recruitment on a CDC funded COVID-19 surveillance study and a qualitative study to evaluate provider perspectives on COVID-19 experiences


Lindsay E. Shade, MHS, PA-C
Clinical Trials and Quality Director

Lindsay attended the University of North Carolina at Chapel Hill and received her undergraduate degree in Exercise and Sport Science with a minor in Chemistry.  In 2006 she graduated from the Duke University Physician Assistant Program with a Master of Health Sciences degree.  She has practiced in Family Medicine in Charlotte, NC ever since and enjoys cultivating relationships with her patients.  Her special interests include pediatrics and women’s health as well as preventative health care.  Lindsay is also a Clinical Associate Professor and the Director of Clinical Trials and Quality within Atrium Health’s Department Family Medicine Research Division.  Current projects focus on chronic disease management, improving participants’ outcomes, implementation, practice facilitation, and using participatory methods including shared decision making.  In her spare time, she enjoys spending time with her husband and two young children, running, practicing yoga, and making jewelry.




Thomas Ludden, PhD
Director of Population Health and Data Analytics

Thomas serves as the Director of Population Health and Data Analytics and has worked with the Department of Family Medicine for 13 years. His research interests include health outcomes research utilizing geospatial models and providing data analytics and study design around patient health outcomes for various studies related to improvements in outcomes for chronic diseases. He has collected and analyzed patient outcomes primarily for patients with diabetes and asthma and provides expertise in designing the appropriate databases to answer proposed research questions. He has also provided extensive guidance around analytics for examining the screening rates for Hepatitis C and HIV. His professional goals include increasing capacity to examine health outcomes data through utilizing electronic medical records to capture patient level information.


David Price, MD
Primary Care Sports Medicine Fellowship Director

 Dr. Price’s research interests include concussion, pre-participation athletic screening and sudden cardiac death in athletes.  Diagnosis and management of concussion currently relies mainly on subjective criteria rather than objective criteria. Currently we are investigating an objective tool to aid in concussion diagnosis and return to play.  We currently host a large pre-participation annual screening event for athletes in the surrounding community which provides a unique opportunity to capture data on athletes regarding depression, blood pressure, cardiac status, and obesity.  Pre-participation screening of athletes serve as a valuable opportunity to screen for depressive symptoms given its increasing prevalence in adolescence. Cardiovascular screening in young athletes is also widely recommended prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. Dr. Price, on behalf of American Medical Society for Sports Medicine, helped author a Position Statement on Cardiovascular Pre-participation Screening in Athletes: Current evidence, knowledge gaps, recommendations, and future directions.  This work has been published in the British Journal of Sports Medicine.



Current Research Studies

Study Title

Major Goal

Principal Investigator

Start Year

End Year








Primary care screening, treatment, and linkage to care for Hepatitis C and HIV for vulnerable populations


To determine whether an Electronic Medical Record alert and provider education along with availability of connect-to-care partners can significantly enhance screening and linkage to care for patients mostly from vulnerable minority populations with regards to HIV.


Hazel Tapp, PhD



Gilead Pharmaceuticals FOCUS initiative $747,000

Evaluation of A Guided Self-Help Intervention for Binge Eating

To test the effectiveness of a culturally specific guided self-help with African American women in primary care who have overeating problems and associated obesity.


Hazel Tapp, PhD

Virginia Gil-Rivas, PhD



Atrium Health/UNCC Collaborative


To identify previously undiagnosed patients with clinically significant COPD, and its impact on clinical care across a broad range of primary care settings. All study activities take place at the patients’ primary care location in order to reduce barriers that deter minority participation in research.


Fernando Martinez, MD

Hazel Tapp, PhD



NIH/NHLBI $500,000

Does Empagliflozin Reduce Cardiovascular Risk Factors and Mortality in Black Patients with Type 2 Diabetes?

Empagliflozin, a diabetes medicine that reduces cardiovascular mortality, has been understudied in African American patients. We are part of a national study that asks whether empagliflozin reduces cardiovascular risk factors and mortality in black patients with type 2 diabetes.


Basem Mishriky, MD

Thomas Ludden, PhD



Eastern Carolina University $3,000

CONNECT HF: Care Optimization through Patient and Hospital Engagement Clinical Trial for Heart Failure


To evaluate different strategies aimed at improving the quality of care and potential for reduction in hospital admissions for patients with heart failure with 91% of study subjects representing minority populations.

Adam DeVore, MD

Jewell Carr, MD



Novartis Pharmaceuticals Corporation $72,500

Evaluation of Virtual Care Visits in a Pandemic Outbreak

To evaluate the rapid expansion/implementation of ambulatory virtual care visits in response to COVID-19 with the aim to examine utilization of virtual care and better understand the patient, provider, clinical team’s experience with the virtual care visit technology, focusing on vulnerable patient populations at Elizabeth Family Medicine, Union Family, Myers Park Internal Medicine, and Myers Park Pediatrics.


Morgan Walls, MD



Atrium Health Internal/Unfunded

(TCC) Piloting of Asthma Community Navigators Within A Managed Care System


To evaluate a peer support program to better understand the social and cultural needs of pediatric asthma patients, and to assist community partners in understanding the benefits and future potential of the peer support program and impact on outcomes for Medicaid asthma patients.


Hazel Tapp, PhD



NIMHD $49,704

UNCC homelessness project

To identify healthcare utilization and cost differences between those housed vs those without housing.

Laurie Thomas, PhD

Thomas Ludden, PhD



Mecklenburg County $5,000

Community Participatory Approach to improving health in a Hispanic population


To outline continued development of a unique research network that will utilize key principles of community-based participatory research (CBPR) to develop and test interventions designed to minimize health inequalities, improve health outcomes, and overcome health disparities for the Hispanic community in Charlotte, NC.


Michael Dulin, MD PhD



NIH/NCMHD $687,000

Comparative Effectiveness of Asthma Interventions within an AHRQ PBRN (ACE)


To advance chronic disease self-management of asthma through Shared Decision Making in a predominantly Medicaid, Medicare, and indigent population.

Michael Dulin, MD PhD



AHRQ $1.9 million

ADAPT-NC: Asthma Dissemination Around Patient-Centered Treatments in North Carolina

To compare the effectiveness of lunch-and-learn (traditional) vs facilitator-led (participatory) dissemination strategies for an SDM intervention, and to determine which strategy resulted in practices more effectively adopting an SDM approach to asthma management. Alternate approaches to care are necessary given that, despite advances in medical knowledge, poor outcomes and disparities persist for patients with asthma, with minority children aged 10-17 bearing a disproportionate share of the healthcare utilization.

Hazel Tapp, PhD



PCORI $2.1 million


Key Publications

  1. Increasing collaboration on substance use disorder research with primary care practices through the National Drug Abuse Treatment Clinical Trials Network. Baldwin LM, Mollis B, Witwer E, Halladay JR, Ludden T, Elder N, Tapp H, Donahue KE, Johnson D, Mottus K, Olson AL, Waddell EN, Dolor RJ. J Subst Abuse Treat. 2020 Mar;112S:34-40. doi: 10.1016/j.jsat.2020.02.009. PMID: 32220408.

  2. The CAPTURE Study: Prevalence of Chronic Obstructive Pulmonary Disease in Primary Care Settings 2020 Yawn, B et al COPD Foundation. Accepted for publication.

  3. Novel Models to Identify Census Tracts for Hepatitis C Screening Interventions. Ludden T, Shade L, Thomas J, de Hernandez BU, Mohanan S, Russo MW, Leonard M, Zamor PJ, Patterson CG, Tapp H. JABFM May 2020, 33 (3) 407-416; DOI: 10.3122/jabfm.2020.03.190305. PMID: 32430372

  4. Electronic medical record alert activation increase hepatitis C and HIV screening rates in primary care practices within a large healthcare system. Tapp H, Ludden T, Shade L, Thomas J, Mohanan S, Leonard M. Prev Med Rep. 2020 Mar; 17: 101036.  Published online 2020 Jan 7. doi: 10.1016/j.pmedr.2019.101036. PMCID: PMC6965743

  5. Patient and provider perspectives on uptake of a shared decision making intervention for asthma in primary care practices. Welch M, Ludden T, Mottus K, Bray P, Hendrickson L, Rees J, Halladay J, Tapp H. J Asthma. Author manuscript; available in PMC 2020 May 1.Published in final edited form as: J Asthma. 2019 May; 56(5): 562–572. Published online 2018 Jun 21.  doi: 10.1080/02770903.2018.1471703. PMCID: PMC6515918

  6. What types of dissemination of information occurred between researchers, providers and clinical staff while implementing an asthma shared decision-making intervention: a directed content analysis. Ludden T, Shade L, Welch M, Halladay J, Donahue KE, Coyne-Beasley T, Bray P, Tapp H. BMJ Open. 2020 Mar 8;10(3):e030883.



Clinical Trial Updates

SURPASS-CVOT - is a diabetes study designed to examine the cardiovasular (CV) protective capabilities of Tirzepatide, a GLP-1 receptor agonist. This is a Phase 3 clinical trial that will assess the effect of once weekly Tirzepatide vs. Dulaglutide (Trulicity) on (CV) outcomes when added to standard of care in Type II Diabetes Mellitus patients with established CV disease. The study is expected to follow patients for 5 to 6 years.

We are currently enrolling patients at Atrium Health Family Medicine and Internal Medicine practices through February 2022. Eligible patients are 40 or over with Type II Diabetes and secific CV risk factors.

Sponsor: Eli Lilly

PI: Dr. Jewell Carr

Research Team: Andrea Price, Amanda Balasco, Faith Ellerbe, Lindsay Shade

CAPTURE - Undiagnosed COPD is a leading cause of morbidity and mortality. Spirometry, the ‘gold standard’ for diagnosis, is not recommended for screening in asymptomatic individuals and remains widely underutilized in primary care settings. Through a simple tool using five questions combined with selective peak expiratory flow measurement, the study seeks to identify individuals suffering from undiagnosed ‘clinically significant’ COPD so they can be treated, resulting in improved health status, reduced exacerbations and decreased morbidity.

To date, we have enrolled 842 patients from 19 practices!

Pl: Hazel Tapp, PhD

Research Team: Andrea Price, Marina Leonidas, Katherine O'Hare, Cody Oliver, Jeremy Thomas, Lindsay Shade

COLOGUARD - The primary objective of the main study, 2019-01, is to test an updated version of Cologuard against the colonoscopy gold standard. The primary objective of the sub-study, 2019-01B, is to collect blood specimens for research use in the development and validation of a blood-based test for colorectal cancer (CRC).

The study is open for enrollment of patients scheduled for screening colonoscopies at Atrium Health endoscopy centers. We have currently enrolled 24 patients.

PI: Dr. Jewel Carr

Research Team: Amanda Balasco, Faith Ellerbe, Jeremy Thomas, Lindsay Shade

PREVENTABLE - is a landmark study of statins in older adults. The study will enroll 20,000 participants from 100 sites across the US. We know statins are effective for reducing the risk of cardiovascular events in individuals with cardiovascular disease and up to age 75 without disease, but limited evidence proves the usefulness of statins for primary prevention in adults over age 75, especially in the setting of multiple chronic conditions. We are hoping to learn if taking a statin (atorvastatin 40 mg vs placebo) could help older adults live well longer by preventing dementia, disability or cardiovascular disease.

Current enrollment = 24

PI: Lindsay Shade, PA-C

Research Team:Faith Ellerbe, Amanda Balasco, Cody Oliver, Dr. Tony Caprio

Engagement in our Community

Elizabeth Family Medicine Patient Advisory Board (PAB)

  • Virtual meetings bring together patients, clinicians, and clinical staff to discuss practice and system issues
  • 2021 topics included Community Clinic Branding with feedback requested from the Atrium Health Marketing Department, Evaluation of Virtual Visits in Primary Care and associated surveys, Mbrace pilot program designed to address social isolation in adult populations, and the RHYTHM NIH grant proposal to address hypertension through a community-based self management support
  • Special thank you to the PAB members for providing a letter of support for the RHYTHM grant application and several members for agreeing to serve as stakeholders 
  • Upcoming meetings will be held as needed during the pandemic, and we are using this "pause" in the regular meeting cadence to recruit new PAB members. If you know an outstanding PAB candidate, please email

2021 PBRN Virtual Conference Presentations

Presenting at national conferences and serving on conference committees allows our Family Medicine Research team to showcase current projects to broader research communities. This networking exposure and sharing of ideas also invites greater team recognition and more opportunities for future research collaborations.

A graphic summarizing points in a presentation by Hazel Tapp, PhD.

Hazel Tapp, PhD, described the use of a community participatory approach to engage stakeholders to guide our recruitment and data collection efforts for a COVID-19 surveillance study aimed at learning about the spread of the virus in local communities and among healthcare workers.

A graphic summarizing points in a presentation by Tom Ludden, PhD.

Tom Ludden, PhD, presented an evaluation of HIV screening to compare pre and post EMR alert activation along with a peer-to-peer educational program. Data was summarized by practice type and race and results showed differing improvement levels based on those data groupings.

A graphic summarizing points in a presentation by Andrea Price.

Andrea Price showcased how our team of research coordinators were charged with creating strategies to proactively reach out to participants to improve communication, participation, and overall participant satisfaction with the COVID-19 surveillance study. Their efforts and ideas were instrumental in study success as it rolled out on a national level.

A graphic summarizing points in a presentation by Kelly Reeves.

Kelly Reeves presented work-in-progress on a study to examine primary care providers' perceived barriers and facilitators to virtual visit utilization during the COVID-19 pandemic. Focusing on 4 community-based primary care clinics, the initial phase of the study used cross-sectional surveys emailed to eligible study participants.