Increasing the health equity and population-level impact of a digital therapeutic for smokers with psychiatric illness

项目摘要 这个独立科学家奖(K02)的目标是寻求五年的培训和受保护的时间来 支持和扩大新设立的独立调查员的工作。候选人的实验室， 获得全民行为健康(ABHA)实验室，得到了最近的R01(家长研究；DA037276； 2020年3月至2025年)，将评估一种新型数字戒烟疗法(DTX)的疗效 专为严重精神疾病患者量身定做。到目前为止，这位候选人的研究重点是 DTX的开发使用以用户为中心的设计研究，并随后使用其有效性测试 临床试验方法学。然而，疗效试验并不总是转化为现实世界的实践，也不是 经过测试的治疗方法总是被种族和少数民族采用。这一差距在 实施科学文献。最近的一项纵向流行病学调查(N=40,181)表明，虽然 有严重心理困扰的非西班牙裔白人的吸烟率在过去的几年里显著下降 在过去的十年里，黑人和拉丁裔的支持率没有明显下降。这一数据突出了 迫切需要开发具有公平人口健康影响的DTX。因此，五年的时间 这一独立科学家奖提供的保护时间将从根本上提高候选人的 目前的研究计划，通过提供以下方面的正式培训和与专家合作者的联系 关键领域：(1)卫生公平和参与性研究，(2)实施科学，(3)DTX的监督， 市场营销和传播。该奖项还将支持一项基于融合混合方法的辅助研究 在RE-AIM框架上，这将审查父母的健康公平和实施科学成果 学习。这一独立科学家奖将提供必要的研究经验和网络 协作者扩大DTX的广泛传播，以应对种族/民族的系统性挑战 有烟草使用障碍和严重精神疾病的少数群体。以及计划中的与 每个关键培训领域的国家专家，这一奖项将建立追求和 通过保护候选人的时间不受临床责任的影响，在未来维持这个研究计划。 在短期内，该裁决将产生初步数据，为设计一项大型务实试验提供参考 将评估DTX在严重精神疾病患者戒烟中的公平传播。在……里面 从长远来看，该奖项将产生一个新的研究机构，严格审查种族和民族不平等 在DTX治疗成瘾中，DTX公平实施和技术转让的新模式 以及为不同的初级科学家提供指导机会，这将延长 这项工作的影响超出了候选人自己的研究计划。

PROJECT ABSTRACT The goal of this Independent Scientist Award (K02) is to seek five years of training and protected time to enable and expand the work of a newly established independent investigator. The candidate’s laboratory, the Access to Behavioral Health for All (ABHA) Lab, is supported by a recent R01 (Parent Study; DA037276; March 2020-2025) that will evaluate the efficacy of a novel digital therapeutic (DTx) for smoking cessation tailored to patients with serious mental illness. The candidate’s research to date has focused on the development of DTx using user-centered design research, and the subsequent testing of their efficacy using clinical trials methodology. However, efficacy trials do not always translate into real-world practice, nor are tested treatments always adopted by racial and ethnic minorities. This gap is well documented in the implementation science literature. A recent longitudinal epidemiological survey (N=40,181) showed that while the smoking rates of Non-Hispanic Whites with serious psychological distress significantly declined over the last decade, no significant declines occurred among their Black and Latino counterparts. This data accentuates the critical need to develop DTx that have an equitable population health impact. Therefore, the five years of protected time provided by this Independent Scientist Award will fundamentally enhance the candidate’s current program of research by providing formal training and contact with expert collaborators in the following key areas: (1) health equity and participatory research, (2) implementation science, and (3) DTx’s oversight, marketing, and dissemination. The award will also support a convergent mixed-methods Ancillary Study based on the RE-AIM framework, that will examine health equity and implementation science outcomes in the Parent Study. This Independent Scientist Award will provide the necessary research experience and network of collaborators to scale up widespread dissemination of DTx addressing the systemic challenges of racial/ethnic minorities with tobacco use disorder and serious mental illness. Along with the planned collaborations with national experts in each of the key training domains, this award will establish the conditions to pursue and maintain this program of research in the future by protecting the candidate’s time from clinical responsibilities. In the short term, the award will generate preliminary data to inform the design of a large pragmatic trial that will evaluate equitable dissemination of DTx for smoking cessation in patients with serious mental illness. In the long term the award will generate a new body of research rigorously examining racial and ethnic inequities in DTx for addiction treatment, a new model for the equitable implementation and technology transfer of DTx among racial/ethnic minorities, and mentoring opportunities for diverse junior scientists that will extend the impact of this work beyond the candidate’s own program of research.