HSR&D Senior Research Career Scientist Award

高铁

• 批准号: 9766725
• 负责人: Nancy R. Kressin
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9766725
• 关键词: Address; Adherence; Affect; American Heart Association; Area; Award; Back; Boston; Caring; Characteristics; Clinical; Collaborations; Communication; Communities; Educational Intervention; Eligibility Determination; Environment; Equilibrium; Faculty; Fostering; Foundations; Funding; Future; Health; Health Insurance; Health Personnel; Health Services; Health Services Accessibility; Healthcare; Healthcare Systems; Hypertension; Individual; Institutional Review Boards; Internet; Intervention Studies; Journals; Knowledge; Mentors; National Health Services; Outcome; Output; Paper; Patient Self-Report; Patients; Philadelphia; Policies; Provider; Psychological Factors; Psychology; Public Health Administration; Publications; Publishing; Quality of life; Race; Recording of previous events; Research; Research Personnel; Resources; Science; Scientist; Self Care; Services; Shapes; Social Environment; Societal Factors; Students; System; Time; Training; United States National Institutes of Health; Universities; Veterans; Work; care outcomes; career; clinical care; disparity reduction; experience; health belief; health care disparity; health care service utilization; health disparity; improved; indexing; medical schools; overtreatment; peer; racial and ethnic disparities; racism; sabbatical; skills training; social; social health determinants; sociodemographics; undergraduate student; uptake

My research has had several foundational intellectual impacts on the fields of health services and disparities/equity research, within VA and the wider academic community. My studies have illustrated how veterans' individual characteristics affect their self-ratings of health and quality of life. Our work found that racial/ethnic disparities among veterans are a function of patient, provider, system, policy, and societal factors, and demonstrated that multi-faceted studies like ours are needed to distinguish the varying effects of each of these types of factors relative to each other. Our findings have shown that race itself recedes in significance when other characteristics that are associated with race (health beliefs, sociodemographics) are accounted for. We have demonstrated that VA healthcare provider communication does not change simply because of educational training and good intentions, but that workflows and systems must be altered to foster changes in practice. Our studies have documented that neither access to nor eligibility for VA care, policies that value equity, nor health insurance reform are sufficient to reduce disparities, though our findings about how policies and aspects of the societal environment affect VA utilization can guide VA policymakers as they estimate demand for VA care. Taken together, the results of my research to date now point me further upstream to the need to address social determinants of health (SDoH), and my future research will focus on how the VA healthcare system can identify and address these needs of veterans, so that their uptake of care and recommended therapies can ultimately improve health outcomes, optimize utilization, and reduce disparities. In the past 3 years, I have published 32 papers (senior author on 12, first author on 6). My H index in the Web of Science, which reflects the impact of my publications, is a 31, comparable to other VA HSR&D Research Career Scientists (exceeding about half of my RCS peers). In addition, the Almetrics scores of several of my highest profile publications place them within the top 5% of research outputs, demonstrating the strong impact of my work. According to Google Scholar, my work has been cited over 8,300 times (>3,000 since 2013). These scores indicate that my research products are being widely read and cited, shaping the state of knowledge in my fields, and informing future research. My very strong and consistent record of funding as a PI dates back to 1994, from VA, the NIH, and foundations including the American Heart Association. I have won $4,381,159 from VA HSR&D and QUERI, not including Research Career Scientist award funding, with NIH funding (as PI) totaling $13,786,483. In the future, I will leverage my seniority and strong track record to further serve VA, help others (locally and nationally) develop into independent investigators and to further develop disparities/equity research through a focus on how addressing SDoH within VA clinical care can reduce disparities and increase equity in veterans' health and healthcare utilization outcomes, optimizing VA resource use (a VA priority area). I aim to: 1. Mentor and train at least 5 students/trainees/fellows/faculty per year, including at least 1 VA HSR&D CDA. 2. Publish at least 8 papers per year, including at least 3 in very high profile journals. 3. Obtain VA HSR&D Merit Review/QUERI funding as PI for at least 2 new projects in the next 2 years. 4. Continue strong VA service by chairing the VA CDA review panel, the Pittsburgh/Philadelphia COIN Steering Committee, and participating in local IRB, search committees, and other VA/non-VA workgroups.

我的研究对卫生服务领域产生了一些基础性的知识影响， 差异/公平研究，在VA和更广泛的学术界。我的研究表明 退伍军人的个人特征影响他们对健康和生活质量的自我评价。我们的研究发现， 退伍军人之间的种族/民族差异是患者，提供者，系统，政策和社会因素的函数， 并表明，需要像我们这样的多方面研究来区分每种药物的不同影响， 这些因素是相互关联的。我们的发现表明种族本身的重要性 当考虑到与种族相关的其他特征（健康信念，社会人口统计学）时。 我们已经证明，VA医疗保健提供者的沟通不会仅仅因为 教育培训和良好的意愿，但工作流程和系统必须改变，以促进变革， 实践我们的研究已经证明，无论是获得或资格的VA护理，政策的价值 公平，也没有医疗保险改革是足以减少差距，虽然我们的研究结果如何政策 社会环境的各个方面影响退伍军人管理局的利用，可以指导退伍军人管理局政策制定者进行估计 对护理的需求。总的来说，我迄今为止的研究结果现在把我进一步指向上游， 我需要解决健康的社会决定因素（SDoH），我未来的研究将集中在如何VA 医疗保健系统可以识别和解决退伍军人的这些需求，使他们的护理和 推荐的治疗方法最终可以改善健康结果，优化利用，并减少差异。 在过去的3年里，我发表了32篇论文（12篇为高级作者，6篇为第一作者）。我的H指数 Web of Science反映了我的出版物的影响力，与其他VA HSR&D Research相当，排名31 职业科学家（超过我的RCS同行的一半）。此外，我的几个学生的Almetrics分数 最引人注目的出版物使他们进入研究成果的前5%，表明了强大的影响力 我的工作。根据Google Scholar，我的作品被引用了8,300多次（自2013年以来超过3,000次）。 这些分数表明我的研究产品被广泛阅读和引用，塑造了 在我的领域的知识，并告知未来的研究。我作为一名PI在资金方面有着非常强大和一贯的记录 可以追溯到1994年，来自VA，NIH和包括美国心脏协会在内的基金会。我赢了 来自VA HSR&D和QUERI的4，381，159美元，不包括与NIH合作的研究职业科学家奖 资金（作为PI）总计13，786，483美元。 在未来，我将利用我的资历和良好的记录，进一步服务退伍军人事务部，帮助他人（当地 发展成为独立的调查员，并进一步发展差异/公平研究 通过关注如何在VA临床护理中解决SDoH可以减少差异并增加公平性， 退伍军人的健康和医疗保健利用结果，优化VA资源使用（VA优先领域）。我的目标是： 1.指导和培训每年至少5名学生/学员/研究员/教师，包括至少1个VA HSR&D CDA。 2.每年至少发表8篇论文，其中至少3篇在知名期刊上发表。 3.在未来2年内，作为PI获得VA HSR&D Merit Review/QUERI资助，至少2个新项目。 4.继续强大的VA服务主持VA CDA审查小组，匹兹堡/费城硬币 指导委员会，并参与当地IRB、检索委员会和其他VA/非VA工作组。