Patient-Centered Strategies to Reduce Disparities in Access to Kidney Transplantation

摘要

ABSTRACT Tanjala S. Purnell, PhD MPH is a second-year Assistant Professor in the Department of Surgery at the Johns Hopkins School of Medicine with a joint faculty appointment in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. She seeks this Mentored Research Scientist Development (K01) Award in patient-centered outcomes research (PCOR) to support her long-term career goal of establishing her independence as a health services researcher and social epidemiologist dedicated to identifying and implementing patient-centered interventions to achieve equity in access to kidney transplantation. During this award, she will pursue a rigorous research and didactic program, including advanced coursework, seminars, and mentored research that will substantially build her skills in developing patient- and stakeholder-engaged interventions to address disparities in access to kidney transplantation for patients with end stage renal disease (ESRD), a condition that results in poor clinical and patient-reported outcomes. Her research and career objectives are closely aligned with the AHRQ's mission of engaging patients and stakeholders in the design and conduct of PCOR to improve clinical and patient-reported outcomes for priority populations. In her research program, Dr. Purnell will characterize the associations of patient and community stressors with disparities in completion of the KT evaluation process (Aim 1). She will also engage patients, family members, health education experts, and clinical providers in the development (Aim 2) and pilot testing (Aim 3) of patient- centered educational materials about the KT evaluation process. These studies were developed based upon direct patient feedback regarding unmet concerns about the KT process and will lay the foundation for future research to test the effectiveness of patient-centered decision support in reducing disparities in access to KT. In her didactic program, she will undergo intensive training in stakeholder-engaged and translational research, qualitative research methods, development of patient-centered interventions, and the design and conduct of randomized clinical trials within the rich training environments of the Johns Hopkins Epidemiology Research Group in Organ Transplantation, Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, Johns Hopkins Center for Health Services and Outcomes Research, and the Welch Center for Prevention, Epidemiology, and Clinical Research. She will receive primary mentorship from Dorry Segev, MD PhD and Lisa A. Cooper, MD MPH and guidance from an exemplary team of faculty advisors and patient stakeholders who are committed to her success and will support the research and didactic goals of this application.