Mentoring new investigators in PMTCT implementation research

 描述（由申请人提供）：该K24提案建立在赞比亚十年的临床和流行病学研究基础上，候选人- Benjamin Chi，MD，MSc -自2003年以来一直居住在赞比亚。这份申请的时间安排与一个重要的职业中期过渡相对应，因为Chi博士将于2015年7月返回美国，以协调他在查佩尔山的北卡罗来纳州大学正在进行的全球研究和培训活动。池博士迄今为止的职业生涯 专注于临床研究和有效性研究。通过这个K24奖，他寻求在实施研究的新兴领域的正式培训。这项工作将大大增加他目前在以病人为导向的研究中的投资组合，使他能够进一步探索成功实施经证实的干预措施的促进者和障碍。他已经招募了一个多学科的教师合作，并支持他在这奋进的努力，一个反映了在实施研究的广度和深度的资源。候选人：迟博士是预防母婴艾滋病毒传播（PMTCT）方面公认的思想领袖。他领导了高影响力的临床试验和有效性研究，并寻求通过发展实施研究的能力来补充这些技能。尽管国家卫生研究院和其他机构的投资不断增加，但目前在预防母婴传播领域缺乏这种专门知识。在国内实施研究中开发的严格方法尚未在国际工作中广泛转化，这是本申请旨在解决的一个差距。指导计划/环境：Chi博士在研究培训方面有着良好的记录，包括领导两个NIH资助的奖学金项目。然而，由于行政责任的竞争，近年来他可用于指导的时间变得有限。在K24的支持下，他将重新致力于指导高级学员（例如，博士后研究员，初级教师），因为他们希望成为独立资助的研究人员。他将利用美国国立卫生研究院的广泛资源来实现这一目标，包括NIH资助的中心和培训项目、网络和合作以及全球卫生机构和部门。研究计划：Chi博士建议研究实施新的护理点（POC）技术，用于早期婴儿艾滋病毒诊断（EID）。POC检测具有很大的前景，但关于其实施的许多因素-包括其集成到现有服务中-尚不清楚。基于一项即将开始的NIH资助的随机研究的框架，Chi博士将确定EID吸收的障碍，并衡量诊断服务实施的“保真度”（即，在多大程度上按设计提供干预措施），比较基于POC的服务与艾滋病毒DNA PCR检测的现行标准。利用从这项试验中获得的数据，他将模拟POC EID和其他相关干预措施的人口影响，以确定在不同环境中推出EID服务的最佳策略。该计划为迟博士的实施研究培训提供了一个框架，同时也为指导未来致力于以患者为导向的研究的研究人员提供了一个平台。

 DESCRIPTION (provided by applicant): This K24 proposal builds upon a decade of clinical and epidemiologic research in Zambia, where the candidate - Benjamin Chi, MD, MSc - has lived since 2003. The application is timed to correspond with an important midcareer transition, as Dr. Chi returns to the U.S. in July 2015 to coordinate his ongoing global research and training activities from the University of North Carolina at Chapel Hill (UNC). Dr. Chi's career to date has focused on clinical research and effectiveness studies. Through this K24 award, he seeks formal training in the burgeoning field of implementation research. This work will greatly augment his current portfolio in patient- oriented research, allowing him to further explore facilitators and barriers to the successful implementation of proven interventions. He has recruited a multidisciplinary faculty to collaborate and support him in this endeavor, one that reflects the breadth and depth of UNC's resources in implementation research. Candidate: Dr. Chi is a recognized thought leader in the prevention of mother-to-child HIV transmission (PMTCT). He has led high-impact clinical trials and effectiveness studies, and seeks to complement these skills by developing capacity in implementation research. Despite growing investment from NIH and others, there is currently a paucity of such expertise in the field of PMTCT. The rigorous methods developed in domestic implementation research have not yet translated widely in international work, a gap this application aims to address. Mentoring Plan/Environment: Dr. Chi has an established track record in research training, including leadership of two NIH-funded fellowship programs. Because of competing administrative responsibilities, however, his available time for mentorship has become limited in recent years. With K24 support, he will rededicate his efforts in the mentoring of advanced trainees (e.g., postdoctoral fellows, junior faculty) as they look to become independently funded investigators. He will leverage UNC's extensive resources to accomplish this goal, including NIH-funded centers and training programs, networks and collaborations, and global health institutes and departments. Research Plan: Dr. Chi proposes to study the implementation of new point-of-care (POC) technologies for early infant diagnosis of HIV (EID). POC assays hold great promise, but many factors regarding their implementation - including their integration into existing services - are yet unknown. Built upon the framework of a soon-to-begin randomized NIH-funded study, Dr. Chi will identify barriers to EID uptake and measure the "fidelity" of diagnostic service implementation (i.e., the extent to which the intervention is delivered as designed), comparing POC-based services to the current standard of HIV DNA PCR testing. Using data obtained from this trial, he will model the population impact of POC EID and other, related interventions to determine optimal strategies for rolling-out EID services across different settings. This plan offers a framework for Dr. Chi's training in implementation research while also providing a platform for mentoring future investigators committed to patient-oriented research.