When she was a pediatrics resident at Stanford University doing her rounds on the hospital wards or seeing patients in her continuity clinic, Eliana Perrin always had many questions for her supervising physicians—questions about why certain children came into care sicker than others, or how the challenges some patients encountered in their day-to-day lives affected their health.
"One astute attending told me, 'You ask lots of questions, and you ask the kinds of questions that can't be answered at the bedside,'" Perrin remembers. The attending physician recommended that Perrin pursue research training to learn how to investigate difficult questions like these and begin to think more upstream than busy clinical practice allows.
While she had always known that she wanted to be a physician and she'd had good experiences as a research assistant in medical school summers, this observation prompted her to apply for the Robert Wood Johnson Clinical Scholars Program, a research training program that would be the beginning of a lifelong career answering difficult questions and tackling what Perrin calls "wicked problems" in children's health.
Combining this natural sense of curiosity, her passion for medicine, and a desire to serve those who have been systematically marginalized, Perrin has established herself as a leader in the fields of primary care and childhood obesity. Her work has had a broad impact on an epidemic that affects one in three children. She has spanned qualitative and quantitative methods and topics—studying inflammatory markers in neonates and developing and testing color-coded growth charts to determine the influence of messages in children's movies, for example—to understand the many facets of childhood obesity and health correlates. Her specific questions often examine what pediatricians can do during well-child checks to support parents in helping children grow up healthy.
"I'm particularly committed to working with families who come from communities that have been systematically disadvantaged and don't always have the resources to eat healthy and be physically active, and looking for ways to help these families fight toxic food environments and help their children grow up healthy," Perrin says.
Perrin will soon join Johns Hopkins University as a Bloomberg Distinguished Professor of primary care. She comes to JHU from Duke University, where she was a professor of pediatrics, division chief for primary care pediatrics, program director for the National Clinician Scholars Program, and founder and director of the Duke Center for Childhood Obesity Research. She will hold primary appointments in the School of Medicine and the School of Nursing, as well as an appointment in the Bloomberg School of Public Health.
"Eliana Perrin has devoted her career to reducing the epidemic of childhood obesity in this country, and she has developed promising interdisciplinary approaches that are specifically targeted to disadvantaged communities," says Paul Rothman, dean of the School of Medicine and CEO of Johns Hopkins Medicine. "Her combination of dedication, caring, and scientific innovation make her an ideal addition to our institution. We could not be more excited that she is joining us at here at Johns Hopkins."
Adds Marie Nolan, interim dean of the School of Nursing: "Dr. Perrin's background and experience in pediatrics, patient-centered care, and preventative medicine will be valuable assets to the school of nursing community. The BDP professorship will help further connect and build our ongoing partnership with the School of Medicine, and provide us with new opportunities for collaboration, shared resources, and interdisciplinary scholarship."
At Johns Hopkins, Perrin plans to continue her groundbreaking work on early childhood obesity prevention through a low literacy primary care intervention program she co-created and has studied called Greenlight. The original cluster randomized trial and a follow-up cohort study of the intervention were both funded by National Institutes of Health R01 grants, a competitive funding mechanism that supports a specific health-related research and development project. They followed 865 parent-child dyads from the 2-month well-child checkup through their five-year-old checkup. One of the first to focus on families that are typically not included in research—50% of participants were Latino, 27% were African American, and almost all had low annual household incomes—the study looked at early feeding, physical activity, screen time, injury prevention, literacy, and health disparities.
"Seeing inequities, seeing differential treatments, and seeing differential outcomes—how broader systems impact the lives of people that we see in the clinic—drives my research," Perrin says. "How do patients come to us with the problems that they have? What is going on in their lives that either helps them stay healthy despite adversity or makes them sicker? These are some of the broader questions that fuel my research interests. Doctors' office visits and care models in general aren't always geared towards people like those in our study, and we very much want to make sure that they are represented."
The next iteration of Greenlight is seeking to learn from the results of Greenlight "1.0" and expand on it by engaging in a comparative effectiveness trial of 900 participants that includes asynchronous care elements such as text messaging goals and support. This study now has six sites nationally and numerous investigators and trainees and is funded by Patient-Centered Outcomes Research Institute.
"Dr. Perrin's approach is exactly what the BDP program is designed to support," says Sunil Kumar, provost of the university. "Not only does she promote an interdisciplinary research ethos, but she lives it—by considering that complex problems have complex answers that require multiple perspectives and methods to address."
Perrin earned her BA in biology and education from Swarthmore College and her MD from the University of Rochester School of Medicine and Dentistry with Alpha Omega Alpha honors. She completed a pediatrics residency at Stanford University before moving to the University of North Carolina at Chapel Hill, where she completed a Robert Wood Johnson Clinical Scholars Fellowship and received an MPH. She remained at UNC on the faculty for more than 16 years. During her final three years before joining Duke University, Perrin served as the associate vice chancellor for research for UNC-Chapel Hill, helping to build interdisciplinary research teams across the university and overseeing the university's office of postdoctoral affairs. Her experiences in this role impacted not only the interdisciplinary nature of Perrin's own research, but also her approach to institutional collaboration.
"Obesity is, by its nature, a 'wicked problem:' a complex phenomenon requiring insights from many disciplines at many levels of analysis to understand and intervene to advance individual and population health across the life course," Perrin explains. "In primary care, like so many other areas, we all come with a professional orientation that we sometimes get stuck in: 'I'm a pediatrician' or 'I'm an internal medicine doctor;' 'I'm a doctor' or 'I'm a nurse;' 'I'm a clinician educator' or 'I'm a researcher.' I think if we orient instead around a common goal of excellence in primary care, we can build a group of people with different backgrounds and areas of expertise that is more than the sum of its parts, synergizing in unique ways to solve problems like obesity—but there are so many others—that we would never have been able to individually."
To work towards the goal of excellence in primary care, Perrin looks forward to leveraging the existing groundwork for collaboration through Johns Hopkins' Primary Care Consortium, an initiative that unifies research, education, policy, public health, quality improvement, community practice, and innovation across the institution in order to improve primary care and related health outcomes. Perrin hopes to build on this framework by emphasizing collaboration and community engagement and enhancing primary care education. To start, Perrin plans on doing a robust listening tour.
"I love the radical interdisciplinarity of bringing people together who may not have realized that they could work together productively," says Perrin. "I think a listening tour is going to be really helpful in strategically planning around the PCC, and making sure that lots of voices are not only being heard but are being heard by the right people. I'm excited to learn what's there, synergize what's there, and energize what's there."
As a Bloomberg Distinguished Professor, Perrin joins an interdisciplinary cohort of scholars working to address major world problems and teach the next generation. The program is backed by a gift from Michael R. Bloomberg, a Johns Hopkins alumnus, founder of Bloomberg LP and Bloomberg Philanthropies, World Health Organization Global Ambassador for Noncommunicable Diseases, United Nations Secretary-General's Special Envoy for Climate Ambition and Solutions and 108th mayor of New York City.