PROMOTING RESEARCH CAREERS AMONG UNDERREPRESENTED MINORITY PHYSICIANS

促进代表性不足的少数族裔医生的研究事业

• 批准号: 10204024
• 负责人: DONNA B JEFFE
• 金额: $ 43.31万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10204024
• 关键词: Accreditation; Address; Affect; African American; Alaska Native; American Indians; American Medical Association; Applications Grants; Association of American Medical Colleges; Award; Biomedical Research; Clinical; Data; Databases; Degree program; Development; Doctor of Philosophy; Ethnic Origin; Event; Faculty; Fellowship; Funding; Gender; Grant; Healthcare; Hispanics; Individual; Information Management; Intervention; Joints; Knowledge; Latino; Link; Literature; Logistic Regressions; Measures; Mediation; Medical; Medical Education; Medicine; Mentors; Methodology; Minority Groups; Modeling; Outcome; Pathogenesis; Pathway interactions; Patient Care; Physicians; Population; Population Heterogeneity; Positioning Attribute; Probability; Public Domains; Race; Research; Research Personnel; Research Project Grants; Research Training; Risk; Scientist; Testing; Time; Training Programs; Underrepresented Minority; Underrepresented Populations; United States National Institutes of Health; Update; Woman; Work; biomedical scientist; career; career development; causal model; cohort; data de-identification; disorder risk; ethnic diversity; ethnic minority population; follow-up; gender disparity; gender diversity; hazard; health disparity; improved; insight; instructor; interest; longitudinal database; medical schools; mid-career faculty; novel; pre-doctoral; professor; racial and ethnic; racial and ethnic disparities; recruit; senior faculty; therapy design; treatment response

Project Summary Physician-scientists (MD-PhDs and other MDs) are uniquely positioned to address national healthcare challenges by combining their clinical perspectives with scientific insight to provide a scientifically rigorous approach to patient care. A diverse biomedical-research workforce is expected to yield a broader spectrum of novel research questions for studying disease risk, pathogenesis and outcomes, response to treatments, and ways to reduce health disparities. However, the physician-scientist workforce remains relatively lacking in racial/ethnic and gender diversity compared to U.S. medical-school graduates. The objective of this project (a second competitive renewal of R01 GM085350) is to identify barriers to and facilitators of research grant applications, resubmissions, and awards among underrepresented groups in the federally funded biomedical- research workforce, including racial/ethnic minority groups (e.g., Black, American Indian/Alaska Native, and Hispanic) and women. Using a database for an entire pre-applicant population of the 1993-2000 national cohort of 129,867 U.S. medical-school matriculants, we address six Aims, examining outcomes in relation to demographic, institutional, research-related, educational/academic, and professional-development variables. Aims 1-4 will identify variables associated with:1) MD-PhD-degree program enrollees' application for and receipt of F30 and F31 pre-doctoral fellowships; 2) medical graduates' application for F32, mentored-K (K01/K08/K23), and R01 grants; 3) applicants' receipt of F32, mentored-K and R01 awards; and 4) re- submission of unfunded applications and subsequent awards. For racial/ethnic and gender disparities in grant application, resubmission, and award outcomes identified in Aims 2-4, Aim 5 will identify causal mechanisms between each of race/ethnicity and gender and each of the outcomes using causal mediation analysis. Aim 6 will identify variables associated with academic-medicine faculty promotion to a senior rank (associate professor or full professor), attrition without promotion, and mean time to event. We will create a unique, longitudinal database of de-identified data for individuals in this national cohort, with new data from the Association of American Medical Colleges, American Medical Association, and the National Institutes of Health Information for Management, Planning, Analysis, and Coordination (IMPAC) II grants database, which has never before been linked to data for an entire national pre-applicant population. We use multivariable logistic regression models to identify variables associated with grant outcomes, and causal mediation analysis to identify causal mechanisms between race/ethnicity and each grant outcome. Subdistribution hazard ratios will measure effects of variables on the instantaneous probability of two competing events, promotion and attrition; subdistribution hazard function is directly linked to the probabilities of these competing events over time. The new knowledge created from this project will inform the design of interventions to promote greater racial/ethnic and gender diversity of the federally funded, physician-scientist research workforce.

项目概要 医师科学家（MD-PhD 和其他 MD）在解决国家医疗保健问题方面具有独特的地位 将他们的临床观点与科学见解相结合，提供科学严谨的挑战 患者护理方法。多元化的生物医学研究人员预计将产生更广泛的研究成果 研究疾病风险、发病机制和结果、治疗反应的新研究问题，以及 减少健康差距的方法。然而，医师科学家队伍仍然相对缺乏 与美国医学院毕业生相比，种族/民族和性别多样性。该项目的目标（ R01 GM085350 的第二次竞争性更新是确定研究资助的障碍和促进因素 联邦政府资助的生物医学领域代表性不足的群体的申请、重新提交和奖励 研究人员，包括少数种族/族裔群体（例如黑人、美洲印第安人/阿拉斯加原住民和 西班牙裔）和女性。使用 1993-2000 年全国所有预申请人口的数据库 我们对 129,867 名美国医学院的预科生进行了研究，提出了六个目标，检查与以下方面相关的结果： 人口、机构、研究相关、教育/学术和专业发展变量。 目标 1-4 将确定与以下相关的变量：1) MD-PhD 学位课程注册者的申请和 获得F30和F31博士前奖学金； 2）医学毕业生申请F32，导师-K (K01/K08/K23) 和 R01 补助金； 3) 申请人获得F32、Mentored-K和R01奖项；和 4) 重新 提交未资助的申请和随后的奖项。补助金中的种族/民族和性别差异 目标 2-4 中确定的申请、重新提交和奖励结果，目标 5 将确定因果机制 使用因果中介分析分析每个种族/民族和性别以及每个结果之间的关系。目标 6 将确定与学术医学教师晋升高级职位相关的变量（副教授 教授或正教授）、没有晋升的人员流失以及平均活动时间。我们将创造一个独特的、 该国家队列中个人的去识别化数据纵向数据库，其中新数据来自 美国医学院协会、美国医学会和美国国立卫生研究院 管理、规划、分析和协调信息 (IMPAC) II 赠款数据库，其中包含 以前从未与整个国家预申请人口的数据相关联。我们使用多变量物流 回归模型来识别与资助结果相关的变量，以及因果中介分析 确定种族/民族与每项资助结果之间的因果机制。次分布风险比将 衡量变量对两个竞争事件（晋升和流失）的瞬时概率的影响； 次分布风险函数与这些竞争事件随时间变化的概率直接相关。这 该项目创造的新知识将为干预措施的设计提供信息，以促进更大程度的种族/族裔 联邦政府资助的医师科学家研究队伍的性别多样性。

项目成果

Competing Risks Analysis of Promotion and Attrition in Academic Medicine: A National Study of U.S. Medical School Graduates.

• DOI: 10.1097/acm.0000000000002441
• 发表时间: 2019-03
• 期刊: Academic medicine : journal of the Association of American Medical Colleges
• 作者: Jeffe DB;Yan Y;Andriole DA
• 通讯作者: Andriole DA

In reply to Akabas and Brass and to Mittwede et al.

回复 Akabas 和 Brass 以及 Mittwede 等人。

• DOI: 10.1097/acm.0000000000000304
• 发表时间: 2014
• 期刊: Academic medicine : journal of the Association of American Medical Colleges
• 作者: Jeffe,DonnaB;Andriole,DorothyA
• 通讯作者: Andriole,DorothyA

EXPLORING REASONS THAT U.S. MD-PHD STUDENTS ENTER AND LEAVE THEIR DUAL-DEGREE PROGRAMS.

• DOI: 10.28945/4622
• 发表时间: 2020
• 期刊: International journal of doctoral studies : IJDS
• 作者: Chakraverty D;Jeffe DB;Dabney KP;Tai RH
• 通讯作者: Tai RH

Student intentions to pursue obstetrics and gynecology training and practice in underserved areas.

学生有意在服务不足的地区接受妇产科培训和实践。

• DOI: 10.1016/j.ajog.2022.09.019
• 发表时间: 2023
• 期刊: American journal of obstetrics and gynecology
• 影响因子: 9.8
• 作者: Martinez,Sarah;Rrapi,Enxhi;Hacker,MicheleR;Nguyen,Mytien;Jeffe,DonnaB;Capellan,Aimee;McKinney,Sara
• 通讯作者: McKinney,Sara

Disparities by Sex in Promotion to Associate Professor Among a National Cohort of Academic Physicians: Causal Mediation Analysis.

全国学术医师队伍中晋升副教授的性别差异：因果中介分析。

• DOI: 10.1097/acm.0000000000005344
• 发表时间: 2023
• 期刊: Academic medicine : journal of the Association of American Medical Colleges
• 作者: Freeman,WilliamE;Yan,Yan;Jeffe,DonnaB
• 通讯作者: Jeffe,DonnaB