Mentoring new investigators in PMTCT implementation research

 描述(由申请人提供)：这份K24提案建立在赞比亚十年的临床和流行病学研究的基础上，候选人本杰明·基，医学博士，硕士-自2003年以来一直居住在赞比亚。这份申请的时机是为了适应一个重要的职业生涯中期过渡，迟浩田将于2015年7月返回美国，协调他在北卡罗来纳大学教堂山分校(UNC)正在进行的全球研究和培训活动。到目前为止，池博士的职业生涯已经 专注于临床研究和疗效研究。通过这个K24奖项，他寻求在新兴的实施研究领域进行正式培训。这项工作将极大地增加他目前在以患者为导向的研究方面的投资组合，使他能够进一步探索成功实施经过验证的干预措施的促进者和障碍。他招募了一个多学科的教员来合作和支持他的这一努力，这反映了北卡罗来纳大学在实施研究方面的资源的广度和深度。候选人：池博士是公认的预防母婴传播艾滋病毒(PMTCT)的思想领袖。他领导了高影响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。尽管来自美国国立卫生研究院和其他机构的投资不断增加，但目前在防止母婴传播领域缺乏此类专业知识。在国内实施研究中开发的严格方法尚未广泛应用于国际工作，这一应用旨在解决这一差距。导师计划/环境：池博士在研究培训方面有既定的记录，包括领导两个由NIH资助的奖学金项目。然而，由于相互竞争的行政责任，他可用于指导的时间近年来变得有限。在K24的支持下，他将再次致力于指导高级实习生(例如，博士后研究员、初级教员)，因为他们希望成为独立资助的研究人员。他将利用北卡罗来纳大学的广泛资源来实现这一目标，包括NIH资助的中心和培训计划、网络和合作以及全球卫生机构和部门。研究计划：池博士建议研究实施新的护理点(POC)技术，用于婴儿艾滋病毒(EID)的早期诊断。POC分析前景看好，但有关其实施的许多因素--包括与现有服务的集成--尚不清楚。在美国国立卫生研究院资助的一项即将开始的随机研究框架的基础上，池博士将确定EID感染的障碍，并衡量诊断服务实施的“保真度”(即干预措施按设计提供的程度)，将基于POC的服务与当前的HIV DNA PCR检测标准进行比较。他将使用从该试验中获得的数据，对POC EID和其他相关干预措施对人口的影响进行建模，以确定在不同环境中推出EID服务的最佳策略。该计划为迟浩田在实施研究方面的培训提供了一个框架，同时也为指导未来致力于以患者为中心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.