Trends in Clinical Research Including Asian American, Native Hawaiian, and Pacific Islander Participants Funded by the US National Institutes of Health, 1992 to 2018
Trends in Clinical Research Including Asian American, Native Hawaiian, and Pacific Islander Participants Funded by the US National Institutes of Health, 1992 to 2018
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DOI：
10.1001/jamanetworkopen.2019.7432
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发表时间：
2019-07-01
影响因子：
13.8
通讯作者：
Irvin, Veronica L.
中科院分区：
文献类型：
--
作者：
Doan, Lan N.;Takata, Yumie;Irvin, Veronica L.
推进亚裔美国人、夏威夷土著人和太平洋岛民（AA/NHPI）个人的健康公平议程已成为联邦机构的交叉优先事项。然而，联邦投资和立法的影响，以确保系统的过程和资源，以消除健康差距AA/NHPI population. ObjectiveTo执行的临床研究由美国国立卫生研究院（NIH）资助的AA/NHPI人群的投资组合审查，并确定在为这些人群服务的NIH投资水平。和参与者横断面研究，其中NIH研究组合在线报告工具支出和结果系统被查询1992年1月1日至2018年12月31日在美国进行的以AA/NHP为重点的校外临床研究项目。包括由研究项目赠款、中心、合作奖、研究职业奖、培训赠款和奖学金资助的临床研究，并对AA/NHPI国家和原产地文化进行了高级文本搜索。筛选项目标题和术语以纳入，并审查项目摘要以验证合格性。描述性分析已完成。主要结果和测量结果包括NIH资助的趋势和资助项目和组织的特点。AA/NHPI相关的资金趋势的比例计算使用2个因子，总NIH支出和临床research expenditures.RESULTS有5460记录确定，其中891研究资格审查。其中，529项临床研究集中在AA/NHPI参与者，占NIH 26年总预算的0.17%。研究AA/NHPI个体以及其他人群的项目在17个NIH研究所和中心获得资助。前5名资助者共同贡献了AA/NHPI项目总资金的近60%，他们是美国国家癌症研究所（231 584 664美元），国家老龄化研究所（108 365 124美元），国家心脏，肺和血液研究所（67 232 910美元），国家少数民族健康和健康差异研究所（62 982 901美元）和国家心理健康研究所（60 072 779美元）。这些项目的资金（775 536 121美元）占1992年至2018年NIH总支出（451 284 075 000美元）的0.17%，占2000年后NIH研究预算的0.18%（677 479 468美元）。AA/NHPI项目的资金随着时间的推移显着增加，但占NIH总预算的比例仅从2000年之前的0.12%增加到2000年之后的0.18%。总资金，60.8%被授予研究项目赠款金相比，只有5.1%分配给研究事业奖，培训赠款，和fellowships.CONCLUSIONS和相关性增加AA/NHPI临床研究的研究经费与整体NIH研究预算的增加，AA/NHPI亚组的代表性不足仍然存在。如果没有来自联邦实体的公开指导和用于健康差异研究的专项资金，以及增加生物医学劳动力多样性的平行努力，AA/NHPI人群的投资可能会继续萎缩。
IMPORTANCE Advancing the health equity agenda for Asian American, Native Hawaiian, and Pacific Islander (AA/NHPI) individuals has become an intersecting priority for federal agencies. However, the impact of federal investments and legislation to ensure systematic processes and resources to eliminate health disparities in AA/NHPI populations is unclear.OBJECTIVE To perform a portfolio review of clinical research funded by the National Institutes of Health (NIH) for AA/NHPI populations and determine the level of NIH investment in serving these populations.DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study in which the NIH Research Portfolio Online Reporting Tools Expenditures and Results system was queried for extramural AA/NHPI-focused clinical research projects conducted in the United States from January 1, 1992, to December 31, 2018. Clinical research funded under research project grants, centers, cooperative awards, research career awards, training grants, and fellowships was included, with an advanced text search for AA/NHPI countries and cultures of origin. Project titles and terms were screened for inclusion and project abstracts were reviewed to verify eligibility. Descriptive analyses were completed.MAIN OUTCOMES AND MEASURES Outcomes included NIH funding trends and characteristics of funded projects and organizations. The proportions of AA/NHPI-related funding trends were calculated using 2 denominators, total NIH expenditures and clinical research expenditures.RESULTS There were 5460 records identified, of which 891 studies were reviewed for eligibility. Of these, 529 clinical research studies focused on AA/NHPI participants composed 0.17% of the total NIH budget over 26 years. Projects studying AA/NHPI individuals in addition to other populations were funded across 17 NIH institutes and centers. The top 5 funders collectively contributed almost 60% of the total funding dollars for AA/NHPI projects and were the National Cancer Institute ($231 584 664), National Institute on Aging ($108 365 124), National Heart, Lung, and Blood Institute ($67 232 910), National Institute on Minority Health and Health Disparities ($62 982 901), and National Institute on Mental Health ($60 072 779). Funding of these projects ($775 536 121) made up 0.17% of the overall NIH expenditures ($451 284 075 000) between 1992 and 2018, and 0.18% ($677 479 468) of the NIH research budget after 2000. Funding for AA/NHPI projects significantly increased over time, but the proportion of the total NIH budget has only increased from 0.12% before 2000 to 0.18% after 2000. Of total funding, 60.8% was awarded to research project grants compared with only 5.1% allocated to research career awards, training grants, and fellowships.CONCLUSIONS AND RELEVANCE Increases in research dollars for AA/NHPI clinical research were not associated with increases in the overall NIH research budget, and underrepresentation of AA/NHPI subgroups still remains. Without overt direction from federal entities and dedicated funds for health disparities research, as well as parallel efforts to increase diversity in the biomedical workforce, investments may continue to languish for AA/NHPI populations.