Yale Clinical and Translational Science Award: Calhoun Diversity in Health Related Research

耶鲁临床和转化科学奖：卡尔霍恩健康相关研究多样性

• 批准号: 10518169
• 负责人: John H. Krystal
• 金额: $ 23.25万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10518169
• 关键词: Academy; Adolescence; Adolescent; Adolescent and Young Adult; Adult; American; Caregivers; Caring; Childhood; Chronic; Clinical Research; Clinical and Translational Science Awards; Cohort Studies; Communities; Data; Development; Disease; Disease Progression; Ensure; Evidence based intervention; Face; Faculty; Foundations; Goals; Guidelines; Health; Health Status; Healthcare; Home; Information Dissemination; Intervention; Knowledge; Life; Longevity; Medical; Mentorship; Methods; Morbidity - disease rate; Multicenter Studies; Outcome; Outcomes Research; Patients; Pediatrics; Penicillins; Physicians; Publishing; Research; Research Methodology; Resource Development; Resources; Risk; Scientist; Sickle Cell Anemia; Streptococcus pneumoniae; Structure; Time; Translational Research; Underrepresented Minority; Vaccination; Work; acceptability and feasibility; base; career; career development; clinical practice; design; health care disparity; health equity; high risk population; implementation science; implementation strategy; improved; intervention mapping; minority investigator; mortality; programs; prophylactic; socioeconomics; therapy design; translational study; uptake

CANDIDATE PROJECT ABSTRACT - With the widespread implementation of evidence-based interventions such as prophylactic penicillin and pneumococcal vaccinations, sickle cell disease (SCD) has evolved from a life-threatening disease of childhood to a chronic condition with a strikingly shortened adult life span. SCD patients are at greatest risk for poor outcomes as they transition from pediatric to adult care, a time in which disease progression and socioeconomic complications converge. Evidence suggests that the implementation of structured transition programs to support patients and caregivers will help mitigate many of the challenges that AYA-SCD face as they navigate this complicated landscape. The American Academy of Pediatrics has published a comprehensive guideline, Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home, which has shown promise in improving transition care for adolescents. Nonetheless, there remains a paucity of structured transition programs for adolescents and young adults with SCD. In this proposal, I will use Implementation Science methods to promote the increased uptake of the AAP guidelines into clinical practice with the long-term goal of increasing the presence of structured transition programs for AYA- SCD. To accomplish this objective, I will use Intervention Mapping, an implementation science-based planning framework, to thoughtfully identify a core set of implementation strategies that will facilitate the development of structured transition programs based on the AAP guidelines (Aim 1). I will then pilot these strategies at a local level to evaluate for feasibility and acceptability (Aim 2). These data will inform a multi- center study aimed at using proven implementation strategies in conjunction with AAP guidelines to facilitate the increase of structured transition programs for AYA-SCD with the long-term goal of decreasing morbidity and mortality in this high risk group which is deeply impacted by healthcare inequities. I will leverage the resources at YCCI to successfully execute the proposed project as well as to develop my expertise in Implementation Science, clinical research methods, health equity and intervention design; this includes didactic coursework offered by YCCI, participation in monthly YCCI Research In Progress seminars and continued participation in the Research Opportunities for Clinical and Translational Studies (ROCATS) cohort which provides foundational knowledge to junior faculty committed to clinical and translational research. I will also engage with the YCCI Cultural Ambassadors during study development, execution and dissemination of results to ensure that my scholarly work reflects the needs of the SCD community. With the guidance of my mentorship team, which includes experts in sickle cell disease, implementation science and health equity outcomes research, and the career development resources provided by YCCI I will achieve my long-term goal of becoming an independent physician-scientist dedicated to improving health outcomes in AYA-SCD through the rigorous design and implementation of multi-level health interventions.

候选项目摘要 - 基于证据的干预措施的广泛实施 例如预防性青霉素和肺炎球菌疫苗，镰状细胞病（SCD）已从A演变 威胁生命的童年疾病至慢性疾病，成人寿命明显缩短。 scd 患者从小儿过渡到成人护理时，患者的预后不良风险是最大的风险， 疾病的进展和社会经济并发症融合。证据表明实施 在支持患者和看护者的结构化过渡计划中，将有助于缓解许多挑战 当Aya-SCD在这一复杂的景观中浏览时。美国儿科学会有 发布了一项全面的指南，支持从青春期到成年的医疗保健过渡 在医疗之家中，这表明了改善青少年过渡护理的希望。尽管如此， 对于患有SCD的青少年和年轻人的结构化过渡计划仍然很少。在这个 提案，我将使用实施科学方法来促进AAP指南的增加的吸收 进入临床实践，其长期目标是增加结构化过渡计划的存在 Aya-Scd。为了实现这一目标，我将使用干预映射，这是一种基于科学的实施 规划框架，深思熟虑地确定一套核心实施策略，以促进 基于AAP指南的结构化过渡计划的制定（AIM 1）。然后我会驾驶这些 在地方一级的策略来评估可行性和可接受性（AIM 2）。这些数据将为多种多样 中心研究旨在结合AAP指南来利用经过验证的实施策略来促进 AYA-SCD结构化过渡计划的增加，其长期目标是降低发病率 和这个高风险群体的死亡率受到医疗保健不平等的影响。我将利用 YCCI的资源成功执行拟议项目，并发展我的专业知识 实施科学，临床研究方法，健康公平和干预设计；这包括教学 YCCI提供的课程工作，参加每月的YCCI研究进行了研讨会，并继续 参与临床和转化研究的研究机会（ROCATS）队列的研究机会 为致力于临床和转化研究的初级教师提供基本知识。我也会 在研究开发，执行和传播结果期间与YCCI文化大使互动 为了确保我的学术工作反映了SCD社区的需求。在我的指导下 指导团队，包括镰状细胞疾病，实施科学和健康公平的专家 成果研究以及YCCI提供的职业发展资源，我将实现我的长期目标 成为一名独立医师科学家，致力于通过 多层健康干预措施的严格设计和实施。