Promoting Diversity and Sustainability in the NIDDK-Supported Research Workforce through Mentoring Early Career Investigators: Focus on Health Equity

通过指导早期职业研究人员促进 NIDDK 支持的研究队伍的多样性和可持续性：关注健康公平

• 批准号: 10797832
• 负责人: Sandra Amaral
• 金额: $ 11.96万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10797832
• 关键词: Address; Advocacy; Algorithms; Award; Black Populations; Childhood; Communities; Data; Data Collection; Data Sources; Dialysis procedure; Disparity; Donor Selection; Education; Educational Curriculum; Electronic Health Record; Eligibility Determination; End stage renal failure; Equity; Ethnic Origin; Evaluation; Face; Faculty; Goals; Health Disparities Research; Health Insurance; Healthcare Systems; Hispanic Populations; Home visitation; Inequity; Information Systems; Infrastructure; Institutional Racism; Insurance Coverage; Internships; Intervention; Interview; Kidney; Kidney Transplantation; Knowledge; Leadership; Life; Link; Living Donors; Master of Science; Mentors; National Institute of Diabetes and Digestive and Kidney Diseases; Neighborhoods; Nephrology; Not Hispanic or Latino; Outcome; Patients; Pediatrics; Policies; Positioning Attribute; Poverty; Process; Publishing; Race; Registries; Renal Replacement Therapy; Renal function; Research; Research Design; Research Methodology; Research Personnel; Research Proposals; Research Support; Residencies; Role; Surveys; Time; Training; Translations; Transplant Recipients; Transplantation; Underrepresented Minority; Underserved Population; United States; Waiting Lists; Work; career; career development; cohort; community based participatory research; disparity reduction; ethnic disparity; follow-up; health disparity; health equity; health inequalities; implementation science; improved; individual patient; marginalized population; method development; minority investigator; national surveillance; programs; racial bias; racial disparity; skills; social; social health determinants; sound; theories; tool; training opportunity; transplant registry

Project Summary/Abstract The broad, long-term objectives of this proposal are two-fold: 1) to provide high-quality mentoring to contribute to the career development of trainees from diverse backgrounds and 2) to advance the quality, rigor and breadth of health equity research in transplantation and pediatric nephrology. For decades, it has been recognized that Blacks and Hispanics are less likely to receive kidney transplantation compared with non-Hispanic whites (NHWs), especially from a living donor. Most published disparities studies have used race/ethnicity as a social construct and attributed differences in transplant access and outcomes to social determinants of health (SDOH). Yet, assessments of SDOH are often limited to race/ethnicity, health insurance status and neighborhood poverty level, and most studies are descriptive with few providing actionable findings to mitigate inequities. Further, proposed interventions are often targeted at the individual patient rather than the healthcare systems that perpetuate systemic racial bias. Another challenge in achieving equity in transplant access lies in the limits of national data. Currently, national surveillance registries capture patients when they begin renal replacement therapy (United States Renal Data System) and when they are waitlisted or transplanted (Scientific Registry of Transplant Recipients), but not what happens during the time in between when patients must undergo transplant referral and evaluation to be deemed transplant eligible. Given this context, the transplant community has asserted a call to action to achieve equity in transplantation by improving rigor, quality and transparency in transplant-related health equity research. Dr. Amaral’s research proposal seeks to move from describing disparities to achieving equity in transplant access and outcomes through research that leverages diverse study designs and varied data sources to identify potentially modifiable healthcare system barriers to transplant access. Two current projects will support this award. The REACH-TRANSPLANT study (R01 DK120886) examines racial/ethnic inequities that arise during recipient and living donor (LD) evaluation, LD selection, and LD follow-up. The study has three aims and applies both primary and secondary data collection, large electronic health records, research cohort data and survey data. The second project, The House Calls Project, focuses on identifying and addressing adverse social determinants of health (SDOH) that interfere with pediatric kidney transplant evaluation completion. This study will use interview and survey data. These studies provide robust training opportunities in health equity research for Dr. Amaral as a mentor and for mentees across many levels and background, making this proposal ideally aligned with the overarching goals of the K26 award mechanism.

项目总结/文摘