Mentoring investigators to improve health outcomes among persons with opioid and tobacco use disorder

摘要 烟草和其他物质使用造成的健康负担以及过量用药死亡率的降低并没有 公平分配的。少数物质使用障碍(SUD)患者获得治疗。为了提高 在提供基于证据的阿片类药物、烟草和其他sud治疗方面的公平，严格的培训是 需要为以患者为导向的成瘾研究(POAR)的下一代调查人员做准备。我是一个 提供综合初级保健和阿片类药物使用障碍(OUD)治疗的普通内科医生 16年来，共同指导奖学金计划，培训全科内科医生在SUD临床护理和研究方面的技能，以及 领导一项研究计划，旨在提高烟草治疗的结果和在患有烟草的人中提供服务 精神健康和自闭症的共生现象。这一职业中期调查员奖将用于支持三个 首要的职业目标。首先，这将使我的研究指导活动正规化并扩展到研究员和 职业生涯初期的教职员工专注于POAR。我将特别专注于指导来自种族/民族的调查人员 在学术医学和NIH资助的研究中代表性不足的少数群体。第二，我会 发展实验和实施科学方法方面的专门知识，以加强干预 优化临床研究成果并将其转化为实际应用。拟议的研究将 使用利益相关者知情的方法来开发和试行灵活的美沙酮治疗干预措施。 这将在OUD治疗中提供灵活的、以患者为中心的、公平的护理服务，并提供 为学员提供实验和实施科学方面的研究性培训平台。最后，我会发展 在学术医学方面的领导技能，以扩大研究培训基础设施，以促进公平和 多样性，并加强POAR的研究培训。推荐的K24应用程序将利用我强大的 现有的研究计划，一支优秀的顾问团队，以及强大的研究和 精神疾病患者的临床护理和SUD支持我的职业发展和 职业生涯初期的调查人员。

ABSTRACT Reductions in the health burden of tobacco and other substance use and of overdose mortality have not been equitably distributed. A minority of persons with substance use disorder (SUD) access treatment. To improve the equity in the delivery of evidence-based treatment of opioid-, tobacco- and other SUD, rigorous training is needed to prepare the next generation of investigators in patient-oriented addictions research (POAR). I am a general internist who has provided integrated primary care and opioid use disorder (OUD) treatment for over 16 years, co-direct fellowship programs to train general internists skills in SUD clinical care and research, and lead a research program that aims to enhance tobacco treatment outcomes and delivery among persons with co-occurring mental health and SUD. This Mid-Career Investigator Award will be used to support three overarching career goals. First, this will formalize and expand my research mentoring activity to fellows and early-career faculty focused on POAR. I will focus particularly on mentoring investigators from racial/ethnic minority groups that are underrepresented in academic medicine and NIH-funded research. Second, I will develop specific expertise in experimental and implementation science methods to enhance intervention optimization and translation of clinical research findings to real-world application. The proposed research will use a stakeholder-informed approach to develop and pilot test a flexible methadone treatment intervention. This will both inform flexible, patient-centered, equitable care delivery in OUD treatment, and provide a platform for research training for mentees in experimental and implementation science. Finally, I will develop leadership skills in academic medicine to expand the research training infrastructure to promote equity and diversity, and enhance research training in POAR. The proposed K24 application will leverage my strong existing research program, an outstanding team of advisors, and robust institutional resources in research and clinical care among persons with mental illness and SUD to support my career development and mentorship of early-career investigators.