HSR&D Senior Research Career Scientist Award

我的研究在卫生服务和医疗服务领域产生了几个基础性的学术影响 差异/公平研究，在退伍军人事务部和更广泛的学术界。我的研究已经说明了 退伍军人的个性特征影响着他们对健康和生活质量的自我评价。我们的工作发现 退伍军人之间的种族/民族差异是患者、提供者、制度、政策和社会因素的函数， 并证明，需要像我们这样的多方面研究来区分每种药物的不同影响 这些类型的因素是相互关联的。我们的发现表明，种族本身的重要性下降了。 如果考虑到与种族相关的其他特征(健康信念、社会人口统计)。 我们已经证明，退伍军人医疗保健提供商的沟通不会仅仅因为 教育培训和良好意愿，但必须改变工作流程和系统，以促进 练习一下。我们的研究证明，无论是获得还是有资格获得退伍军人管理局的护理，这些政策都是 公平，医疗保险改革也不足以减少差距，尽管我们关于保单如何 影响退伍军人管理局利用的社会环境方面可以指导退伍军人政策制定者估计 对退伍军人管理局护理的需求。综上所述，到目前为止我的研究结果表明，我将进一步向上游 需要解决健康的社会决定因素(SDoH)，我未来的研究将集中在退伍军人管理局如何 医疗保健系统可以识别和解决退伍军人的这些需求，以便他们对护理和 推荐的疗法最终可以改善健康结果，优化利用，减少差异。 在过去的3年里，我发表了32篇论文(高级作者12篇，第一作者6篇)。我的H指数在 科学网，反映了我的出版物的影响，是31，可与其他退伍军人事务部HSR&D研究 职业科学家(超过我的RCS同龄人的大约一半)。此外，我的几个人的Almetrics分数 最引人注目的出版物将它们放在研究产出的前5%之列，展示了其强大的影响力 我的作品。根据谷歌学者的数据，我的工作被引用了8300多次(自2013年以来被引用了3000次)。 这些分数表明，我的研究产品正在被广泛阅读和引用，塑造了 在我的领域的知识，并为未来的研究提供信息。作为一名私募股权投资公司，我有着非常强大和始终如一的资助记录 可追溯到1994年，来自退伍军人事务部、美国国立卫生研究院和包括美国心脏协会在内的基金会。我赢了 来自退伍军人事务部HSR&D和QUERI的4,381,159美元，不包括NIH的研究职业科学家奖资金 资金总额(按PI计算)为13,786,483美元。 在未来，我将利用我的资历和良好的记录来进一步服务退伍军人管理局，帮助他人(在当地 和国家)发展成为独立的调查人员，并进一步发展差异/公平研究 通过重点关注在退伍军人管理局临床护理中解决SDoH如何减少差距和增加公平性 退伍军人的健康和医疗保健利用成果，优化退伍军人资源使用(退伍军人管理局优先领域)。我的目标是： 1.每年至少指导和培训5名学生/实习生/研究员/教职员工，包括至少1名退伍军人事务部HSR&D CDA。 2.每年至少发表8篇论文，其中至少3篇发表在备受瞩目的期刊上。 3.在未来两年内为至少2个新项目获得VA HSR&D功绩审查/QUERI资金作为PI。 4.通过主持退伍军人事务部CDA审查小组-匹兹堡/费城硬币-继续强大的退伍军人事务部服务 指导委员会，并参加地方IRB、搜索委员会和其他退伍军人管理局/非退伍军人管理局工作组。

My research has had several foundational intellectual impacts on the fields of health services and disparities/equity research, within VA and the wider academic community. My studies have illustrated how veterans' individual characteristics affect their self-ratings of health and quality of life. Our work found that racial/ethnic disparities among veterans are a function of patient, provider, system, policy, and societal factors, and demonstrated that multi-faceted studies like ours are needed to distinguish the varying effects of each of these types of factors relative to each other. Our findings have shown that race itself recedes in significance when other characteristics that are associated with race (health beliefs, sociodemographics) are accounted for. We have demonstrated that VA healthcare provider communication does not change simply because of educational training and good intentions, but that workflows and systems must be altered to foster changes in practice. Our studies have documented that neither access to nor eligibility for VA care, policies that value equity, nor health insurance reform are sufficient to reduce disparities, though our findings about how policies and aspects of the societal environment affect VA utilization can guide VA policymakers as they estimate demand for VA care. Taken together, the results of my research to date now point me further upstream to the need to address social determinants of health (SDoH), and my future research will focus on how the VA healthcare system can identify and address these needs of veterans, so that their uptake of care and recommended therapies can ultimately improve health outcomes, optimize utilization, and reduce disparities. In the past 3 years, I have published 32 papers (senior author on 12, first author on 6). My H index in the Web of Science, which reflects the impact of my publications, is a 31, comparable to other VA HSR&D Research Career Scientists (exceeding about half of my RCS peers). In addition, the Almetrics scores of several of my highest profile publications place them within the top 5% of research outputs, demonstrating the strong impact of my work. According to Google Scholar, my work has been cited over 8,300 times (>3,000 since 2013). These scores indicate that my research products are being widely read and cited, shaping the state of knowledge in my fields, and informing future research. My very strong and consistent record of funding as a PI dates back to 1994, from VA, the NIH, and foundations including the American Heart Association. I have won $4,381,159 from VA HSR&D and QUERI, not including Research Career Scientist award funding, with NIH funding (as PI) totaling $13,786,483. In the future, I will leverage my seniority and strong track record to further serve VA, help others (locally and nationally) develop into independent investigators and to further develop disparities/equity research through a focus on how addressing SDoH within VA clinical care can reduce disparities and increase equity in veterans' health and healthcare utilization outcomes, optimizing VA resource use (a VA priority area). I aim to: 1. Mentor and train at least 5 students/trainees/fellows/faculty per year, including at least 1 VA HSR&D CDA. 2. Publish at least 8 papers per year, including at least 3 in very high profile journals. 3. Obtain VA HSR&D Merit Review/QUERI funding as PI for at least 2 new projects in the next 2 years. 4. Continue strong VA service by chairing the VA CDA review panel, the Pittsburgh/Philadelphia COIN Steering Committee, and participating in local IRB, search committees, and other VA/non-VA workgroups.