Promoting Diversity and Sustainability in the NIDDK-Supported Research Workforce through Mentoring Early Career Investigators: Focus on Health Equity

通过指导早期职业研究人员促进 NIDDK 支持的研究队伍的多样性和可持续性：关注健康公平

• 批准号: 10797832
• 负责人: Sandra Amaral
• 金额: $ 11.96万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10797832
• 关键词: Address; Advocacy; Algorithms; Award; Black Populations; Childhood; Communities; Data; Data Collection; Data Sources; Dialysis procedure; Disparity; Donor Selection; Education; Educational Curriculum; Electronic Health Record; Eligibility Determination; End stage renal failure; Equity; Ethnic Origin; Evaluation; Face; Faculty; Goals; Health Disparities Research; Health Insurance; Healthcare Systems; Hispanic Populations; Home visitation; Inequity; Information Systems; Infrastructure; Institutional Racism; Insurance Coverage; Internships; Intervention; Interview; Kidney; Kidney Transplantation; Knowledge; Leadership; Life; Link; Living Donors; Master of Science; Mentors; National Institute of Diabetes and Digestive and Kidney Diseases; Neighborhoods; Nephrology; Not Hispanic or Latino; Outcome; Patients; Pediatrics; Policies; Positioning Attribute; Poverty; Process; Publishing; Race; Registries; Renal Replacement Therapy; Renal function; Research; Research Design; Research Methodology; Research Personnel; Research Proposals; Research Support; Residencies; Role; Surveys; Time; Training; Translations; Transplant Recipients; Transplantation; Underrepresented Minority; Underserved Population; United States; Waiting Lists; Work; career; career development; cohort; community based participatory research; disparity reduction; ethnic disparity; follow-up; health disparity; health equity; health inequalities; implementation science; improved; individual patient; marginalized population; method development; minority investigator; national surveillance; programs; racial bias; racial disparity; skills; social; social health determinants; sound; theories; tool; training opportunity; transplant registry; Address; Advocacy; Algorithms; Award; Black Populations; Childhood; Communities; Data; Data Collection; Data Sources; Dialysis procedure; Disparity; Donor Selection; Education; Educational Curriculum; Electronic Health Record; Eligibility Determination; End stage renal failure; Equity; Ethnic Origin; Evaluation; Face; Faculty; Goals; Health Disparities Research; Health Insurance; Healthcare Systems; Hispanic Populations; Home visitation; Inequity; Information Systems; Infrastructure; Institutional Racism; Insurance Coverage; Internships; Intervention; Interview; Kidney; Kidney Transplantation; Knowledge; Leadership; Life; Link; Living Donors; Master of Science; Mentors; National Institute of Diabetes and Digestive and Kidney Diseases; Neighborhoods; Nephrology; Not Hispanic or Latino; Outcome; Patients; Pediatrics; Policies; Positioning Attribute; Poverty; Process; Publishing; Race; Registries; Renal Replacement Therapy; Renal function; Research; Research Design; Research Methodology; Research Personnel; Research Proposals; Research Support; Residencies; Role; Surveys; Time; Training; Translations; Transplant Recipients; Transplantation; Underrepresented Minority; Underserved Population; United States; Waiting Lists; Work; career; career development; cohort; community based participatory research; disparity reduction; ethnic disparity; follow-up; health disparity; health equity; health inequalities; implementation science; improved; individual patient; marginalized population; method development; minority investigator; national surveillance; programs; racial bias; racial disparity; skills; social; social health determinants; sound; theories; tool; training opportunity; transplant registry

Project Summary/Abstract The broad, long-term objectives of this proposal are two-fold: 1) to provide high-quality mentoring to contribute to the career development of trainees from diverse backgrounds and 2) to advance the quality, rigor and breadth of health equity research in transplantation and pediatric nephrology. For decades, it has been recognized that Blacks and Hispanics are less likely to receive kidney transplantation compared with non-Hispanic whites (NHWs), especially from a living donor. Most published disparities studies have used race/ethnicity as a social construct and attributed differences in transplant access and outcomes to social determinants of health (SDOH). Yet, assessments of SDOH are often limited to race/ethnicity, health insurance status and neighborhood poverty level, and most studies are descriptive with few providing actionable findings to mitigate inequities. Further, proposed interventions are often targeted at the individual patient rather than the healthcare systems that perpetuate systemic racial bias. Another challenge in achieving equity in transplant access lies in the limits of national data. Currently, national surveillance registries capture patients when they begin renal replacement therapy (United States Renal Data System) and when they are waitlisted or transplanted (Scientific Registry of Transplant Recipients), but not what happens during the time in between when patients must undergo transplant referral and evaluation to be deemed transplant eligible. Given this context, the transplant community has asserted a call to action to achieve equity in transplantation by improving rigor, quality and transparency in transplant-related health equity research. Dr. Amaral’s research proposal seeks to move from describing disparities to achieving equity in transplant access and outcomes through research that leverages diverse study designs and varied data sources to identify potentially modifiable healthcare system barriers to transplant access. Two current projects will support this award. The REACH-TRANSPLANT study (R01 DK120886) examines racial/ethnic inequities that arise during recipient and living donor (LD) evaluation, LD selection, and LD follow-up. The study has three aims and applies both primary and secondary data collection, large electronic health records, research cohort data and survey data. The second project, The House Calls Project, focuses on identifying and addressing adverse social determinants of health (SDOH) that interfere with pediatric kidney transplant evaluation completion. This study will use interview and survey data. These studies provide robust training opportunities in health equity research for Dr. Amaral as a mentor and for mentees across many levels and background, making this proposal ideally aligned with the overarching goals of the K26 award mechanism.

项目摘要/摘要 该提案的广泛，长期目标是两方面：1）提供高质量的指导以做出贡献 从潜水员背景的学员的职业发展和2）提高质量，严格和 移植和小儿肾脏病的健康公平研究的广度。 几十年来，人们认识到黑人和西班牙裔不太可能接受肾脏移植 与非西班牙裔白人（NHW）相比，尤其是来自活的捐助者。大多数发表的分销研究 将种族/种族用作社会结构，并将移植访问和结果的差异归因于 卫生的社会决定者（SDOH）。但是，对SDOH的评估通常仅限于种族/种族，健康 保险状况和邻里贫困水平，大多数研究具有描述性，很少有 可行的发现可以减轻不平等现象。此外，建议的干预措施通常针对个人 患者而不是延续全身种族偏见的医疗保健系统。实现的另一个挑战 移植访问权益的权益在于国家数据的限制。目前，国家监视注册机构占有 患者开始肾脏替代疗法（美国肾脏数据系统）时， 等待列表或移植（移植接受者的科学注册表），但没有在此期间发生的事情 在患者必须接受移植转诊和评估之间才能被视为有资格。 鉴于这种情况，移植社区已主张采取行动以实现移植的公平 通过提高与移植相关的健康公平研究的严格，质量和透明度。 Amaral博士的研究 提案试图从描述差异转化为实现移植访问和结果的公平性 通过利用潜水员研究设计和各种数据源的研究，以识别潜在的 可修改的医疗保健系统障碍移植。当前两个项目将支持该奖项。这 Reach-Transplant研究（R01 DK120886）研究了接受者和 Living捐助者（LD）评估，LD选择和LD随访。这项研究具有三个目标，并适用 初级和次要数据收集，大型电子健康记录，研究队列数据和调查数据。 第二个项目是房屋呼叫项目，重点是识别和解决广告社交 卫生的决定因素（SDOH）干扰小儿肾脏移植评估的完成。这项研究 将使用访谈和调查数据。这些研究为健康公平研究提供了强大的培训机会 对于Amaral博士，作为许多层次和背景的精神和导师 与K26奖励机制的总体目标保持一致。