A Mentoring Program in Patient-Oriented Tobacco Dependence and Implementation Science Research

尽管过去50年来在降低吸烟率方面取得了进展，但烟草使用仍然是主要原因 在美国过早死亡。确保致力于解决烟草问题的持续和有效的研究 使用，需要严格的跨学科指导计划来培养下一代研究人员 致力于该领域的患者导向研究（POR）。我领导了一个成功的研究项目， 测试方法，以提高烟草治疗的使用和有效性21年。对于所述第一周期 在我的K24中，我的主要指导目标是进行指导培训，并使指导正规化和加强 我从2001年至2017年参与的活动转变为结构化，一致和全面的指导 计划在烟草POR的学生，研究员和初级教师。在K24的支持下，我 为21名新学员提供培训，学员撰写了50篇论文，7篇论文正在审查或修订中 （学员总数超过230人）和32笔赠款，包括5名K和11名R 01，3名作为新研究者PI，而25名 在过去的17年里，有34篇关于学员的出版物，以及2个K和2个R 01。对于第一个周期， K24，我的主要研究目标是通过建立实施方面的专业知识来提高我的烟草POR 科学通过培训和试点测试使用尼古丁代谢物比例（NMR）-一个遗传信息 尼古丁代谢率的生物标志物-用于个性化烟草治疗作为实施策略， 增加烟草治疗的使用。K24在过去4年的支持，导致了6个新的赠款在烟草和 实施科学，4专注于在临床实践中测试核磁共振：艾滋病毒护理、初级保健和住院患者 (R01 CA243914; U54 GM104941; P50 CA244690; R01 HG012670; SAP#4100083101; R01 DA056050）。我 利用这项研究在实施科学，以加强我的指导，担任教师在两个国家 实施科学培训计划- NCI的传播和实施培训学院 癌症研究和华盛顿大学圣路易斯分校实施科学研究所学者- 并担任癌症中心戒烟倡议的实施科学工作组的联合主席。 在这次更新中，我将：1）维持烟草和实施科学POR的指导计划， 第一个K24周期建立，使用结构化，全面和个性化的方法， 增加15名学员; 2）通过开展试点，增强我们的烟草和实施科学POR 研究为HIV+患者和传染病临床医生提供行为经济学信息 与转诊（临床医生）或参与（患者）烟草使用治疗的意图相关，然后进行测试 将这些信息作为实施科学战略纳入电子健康记录的影响 增加艾滋病毒临床环境中烟草治疗的实际转诊和参与。此次更新将 确保我继续提供培养下一代科学家所需的指导，以解决 烟草使用，并继续发展我在烟草控制和实施科学方面的有影响力的研究。

Despite progress over the past 50 years in lowering the rate of smoking, tobacco use remains the leading cause of premature death in the US. To ensure the sustained and impactful research dedicated to addressing tobacco use, rigorous inter-disciplinary mentoring programs are needed to prepare the next generation of researchers committed to patient-oriented research (POR) in this area. I have led a successful research program focused on testing methods to improve the use and effectiveness of treatments for tobacco for 21 years. For the first cycle of my K24, my primary mentorship goal was to train in mentorship and to formalize and enhance the mentoring activities that I had been engaged in from 2001-2017 into a structured, consistent, and comprehensive mentoring program in tobacco POR for students, fellows, and junior faculty. With K24 support over the past 4 years, I provided training to 21 new mentees, yielding 50 papers with mentees and 7 papers under review or in revision (>230 total by mentees) and 32 grants, including 5 Ks and 11 R01s, 3 as a New Investigator PI, compared to 25 mentees, 34 publications with mentees, and 2 Ks and 2 R01s in the preceding 17 years. For the first cycle of the K24, my primary research goal was to augment my tobacco POR by building expertise in implementation science through training and by pilot testing use of the nicotine metabolite ratio (NMR) – a genetically-informed biomarker of nicotine metabolism rate – for personalizing tobacco treatment as an implementation strategy to increase use of tobacco treatments. K24 support over the past 4 years, led to six new grants in tobacco and implementation science, 4 focused on testing the NMR in clinical practice: HIV care, primary care, and in-patients (R01 CA243914; U54 GM104941; P50 CA244690; R01 HG012670; SAP#4100083101; R01 DA056050). I leveraged this research in implementation science to augment my mentoring by serving as faculty on two national implementation science training programs – NCI's Training Institute for Dissemination and Implementation Research in Cancer and Washington University at St. Louis's Institute for Implementation Science Scholars – and by serving as co-chair for the Cancer Center Cessation Initiative's Implementation Science Working Group. In this renewal, I will: 1) sustain the mentoring program in tobacco and implementation science POR that I established with the first K24 cycle, using a structured, comprehensive, and individualized approach for an additional 15 mentees; and 2) augment our tobacco and implementation science POR by conducting a pilot study to develop messages informed by behavioral economics for HIV+ patients and infectious disease clinicians that are related to intention to refer for (clinician) or engage with (patient) tobacco use treatment and then test the impact of these messages integrated into the electronic health record as implementation science strategies to increase actual referral for and engagement in tobacco treatment in the HIV clinical setting. This renewal will ensure that I continue to provide the mentoring needed to build the next generation of scientists to address tobacco use and to continue to grow my impactful research in tobacco control and implementation science.