RESEARCH TRAINING AND EDUCATION CORE

研究培训和教育核心

• 批准号: 9369109
• 负责人: Marjorie K. Leimomi Mala Mau
• 金额: $ 13.93万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-11-01 至 2017-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9369109
• 关键词: Address; Affect; Alaska Native; Area; Awareness; Behavioral Risk Factor Surveillance System; Biometry; Caring; Clinical; Clinical Trials; Communities; Complex; Cost effectiveness research; Counseling; Cultural Backgrounds; Data; Data Analyses; Data Set; Development; Diabetes Mellitus; Discipline; Discipline of Nursing; Disease; Effectiveness; Ethnic Origin; Ethnic group; Exposure to; Faculty; Filipino; Fostering; Goals; Grant; Hawaii; Hawaiian population; Health; Health Status; Housing; Instruction; Intervention; Lead; Life Expectancy; Link; Malignant Neoplasms; Measures; Medicare; Methodology; Methods; Nature; New Zealand; Nurses; Obesity; Outcome; Pacific Island Americans; Participant; Patients; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Physicians; Population; Populations at Risk; Prevalence; Preventive Intervention; Provider; Public Health; Quality of life; Race; Recruitment Activity; Registries; Research; Research Methodology; Research Personnel; Research Training; Services; Socioeconomic Status; Students; Syndrome; Techniques; Thinking; Time; Training; Training and Education; Translating; Travel; Underrepresented Groups; Universities; Ursidae Family; Vulnerable Populations; base; burden of illness; career; case-based; comparative; comparative effectiveness; cost; design; disparity reduction; doctoral student; effectiveness research; graduate student; health disparity; health equity; human capital; improved; improved outcome; indexing; innovation; interest; investigator training; lectures; meetings; minority investigator; novel strategies; research study; satisfaction; skills; statistics; student training; success; therapy development; treatment choice

While the extent of disparities related to race, ethnicity, and socioeconomic status in Hawai'i is large, the number of investigators trained to analyze these disparities is not. The goal of the Research Training and Education Core is to develop a diverse scientific workforce to study health disparities and promote health equity, which is one of the central goals of the Center grant renewal. The outcomes described above are expected to have an important positive impact because increasing the number of investigators interested in health disparities research, improving their skill sets, and exposing them to trans-disciplinary approaches will enhance our ability to conduct innovative, comprehensive, well-designed research studies to reduce disparities and improve the health of vulnerable populations in Hawai'i and other similar at-risk populations in the Pacific and globally. Unless we invest now in building the human capital essential to understanding the nature and reasons for gaps in quality and outcomes of care, we will lessen our ability to address these disparities and improve outcomes for vulnerable populations. While overall health status in Hawai'i, whether measured by life expectancy or quality of life, is very high, Hawai'i is burdened with considerable inequities in health outcomes related to race, ethnicity, and socioeconomic status. Prominent among these disparities is the lower life expectancy and increased prevalence of disease among Native Hawaiians and other Pacific Islanders [Bitton et al.; Mau et al.; Grandinetti et al.; Maskarinec et al; Aluli et al; Harris and Jones]. Recognizing this, many investigators are interested in conducting research studies to better understand the nature and origins of these disparities, and to follow this exploratory research with targeted interventions. There are critical barriers, however, limiting investigator ability to develop the skills necessary to conduct health disparities research. Availability of instruction and statistical support are two other important issues (Specific Aims 1). There are very few courses offered at the University of Hawai'i focused on applied biostatistics. Nationally, there is an upsurge of available techniques and approaches to measuring disparities that go beyond clinical trials. These approaches focus on real world effectiveness rather than efficacy and have shorter time horizons, increasing their ability to be translated into actionable interventions. The Research Training and Education Core would fill this gap by providing a course on case-based research methodology and another course on comparative effectiveness analysis and health disparities research to doctoral students and junior faculty. Our lectures to master- and doctoral-level students regarding these methodologies will hopefully spark interest in the field at a critical point as they begin to focus on specific research topics. Assembling data can also be costly and time consuming but there are economies of scale. If we house large data sets and develop expertise, we can support many students and junior faculty. The Core would house and make available to students and faculty data for health disparities research (Specific Aim 2). The content of these datasets will depend on the interest of participants, but might include a diabetes registry created by the Center, Medicare Public Use Files (http://www.cms.gov/BSAPUFS) linked with SEER cancer data (http://seer.cancer.gov), and local and national Behavioral Risk Factor Surveillance System Data (http://www.cdc.aov/BRFSS: http://hawaii.gov/health/neighbor/statistics/brfss/brfss/index.html). An additional barrier is the "silo" approach that is often taken to reduce disparities [Marmot et al.]. For example, public health has approaches based on community-based initiatives, physicians and nurses tend to take a case by case counseling approach, pharmacists discuss medications, and alternative care providers focus on their treatment of choice. However, the problem of obesity, and other components of Cardiometabolic Syndrome, is too complex to tackle from a single perspective. By training students and investigators from various disciplines in the same course, we hope to encourage the development of a trans-disciplinary research perspective and to foster the development of interdisciplinary teams (Specific Aim 3) among young investigators. Trans-disciplinary approaches have been shown to lead to significant advances in understanding and reducing health disparities [Emmons et al]. If the proposed aims of this study are achieved and more researchers are inspired and trained in health disparities research, we believe significant advances can be made in the field that can be used to guide the development of treatments, services, and preventative interventions to achieve desired outcomes for vulnerable populations in Hawai'i.

虽然夏威夷的种族、民族和社会经济地位的差异很大， 接受过分析这些差异培训的调查人员的数量并不多。研究培训的目标和 教育的核心是发展一支多元化的科学队伍，以研究健康差距和促进健康 公平，这是该中心赠款更新的中心目标之一。 上述成果预计将产生重要的积极影响，因为增加 许多调查人员对健康差异研究感兴趣，提高他们的技能，并暴露他们 跨学科的方法将提高我们的能力，进行创新，全面，精心设计 研究，以减少差距，改善夏威夷和其他地区弱势群体的健康 太平洋和全球面临类似风险的人群。 除非我们现在就投资于建设对理解差距的性质和原因至关重要的人力资本， 在医疗质量和结果方面，我们将降低解决这些差距和改善结果的能力 为弱势群体提供援助。 虽然夏威夷的总体健康状况，无论是以预期寿命还是生活质量来衡量，都非常高， 夏威夷在与种族、民族和宗教有关的健康结果方面存在相当大的不平等， 社会经济地位。这些差距中最突出的是预期寿命较低， 夏威夷原住民和其他太平洋岛民的疾病流行率[Bitton等人; Mau等人; Grandinetti 等; Maskarinec等人; Aluli等人; Harris和Jones]。认识到这一点，许多研究人员对 进行研究，以更好地了解这些差异的性质和根源，并遵循这一点， 有针对性的干预措施的探索性研究。 然而，存在一些关键障碍，限制了调查人员发展开展健康调查所需技能的能力。 差距研究。提供指导和统计支持是另外两个重要问题（具体 1）。夏威夷大学提供的应用生物统计学课程很少。 在全国范围内，衡量差距的现有技术和方法激增， 超越临床试验。这些方法侧重于真实的世界的有效性，而不是功效， 缩短时限，提高将其转化为可采取行动的干预措施的能力。研究 培训和教育核心将通过提供基于案例的研究方法课程来填补这一空白 另一门课程是为博士生开设的比较有效性分析和健康差异研究课程 和初级教员我们为硕士和博士生举办的关于这些方法论的讲座将 希望在他们开始专注于特定研究主题的关键点上激发对该领域的兴趣。 收集数据也可能是昂贵和耗时的，但有规模经济。如果我们的房子大 数据集和发展专业知识，我们可以支持许多学生和初级教师。核心将容纳和 向学生和教职员工提供健康差异研究数据（具体目标2）。 这些数据集的内容将取决于参与者的兴趣，但可能包括糖尿病登记 由该中心创建，与SEER癌症相关的Medicare公共使用文件（http：//www.cms.gov/BSAPUFS 数据（http：//www.example.com），以及地方和国家行为风险因素监测系统数据 (http http：//www.cdc.aov/BRFSS/http：//hawaii.gov/health/neighbor/Aromatics/brfss/brfss/index.html）。 另一个障碍是"筒仓"方法，通常用于减少差异[Marmot等人]。为 例如，公共卫生的方法是基于社区的倡议，医生和护士往往 采取个案咨询方法，药剂师讨论药物，替代护理提供者 专注于他们的治疗选择。然而，肥胖问题和心脏代谢的其他成分 综合症，太复杂了，不能从一个单一的角度来处理。通过培训学生和调查人员， 在同一门课程中，我们希望鼓励跨学科研究的发展 在青年人中培养跨学科团队（具体目标3） investigators.跨学科的方法已被证明会导致重大进展， 了解和减少健康差距[Emmons等人]。 如果这项研究的目标得以实现，更多的研究人员受到启发和培训， 通过差异研究，我们相信可以在该领域取得重大进展， 发展治疗、服务和预防性干预措施，以实现预期的结果， 夏威夷的弱势群体