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（K 02）的目标是寻求五年的培训和保护时间， 使新设立的独立调查员能够开展并扩大其工作。候选人的实验室， 访问行为健康为所有（ABHA）实验室，是由最近的R 01（家长研究; DA 037276; 2020年3月至2025年），将评估一种新型数字治疗（DTx）戒烟的疗效 专为患有严重精神疾病的患者量身打造迄今为止，候选人的研究集中在 使用以用户为中心的设计研究开发DTx，并使用 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， 少数种族和少数民族一直采用的经过测试的治疗方法。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）显示， 有严重心理困扰的非西班牙裔白人的吸烟率在2008年显著下降。 在过去的十年中，黑人和拉丁美洲人的人数没有明显下降。这一数据强调了 迫切需要开发具有公平人口健康影响的DTx。因此， 这项独立科学家奖提供的受保护的时间将从根本上提高候选人的 通过提供正式的培训和与以下专家合作者的联系， 关键领域：（1）健康公平和参与性研究，（2）实施科学，（3）DTx的监督， 营销和传播。该奖项还将支持一个融合的混合方法辅助研究， 在RE-AIM框架上，将检查父母的健康公平和实施科学成果， Study.该独立科学家奖将提供必要的研究经验和网络， 合作者扩大DTx的广泛传播，解决种族/民族的系统性挑战 患有烟草使用障碍和严重精神疾病的少数民族。沿着计划中的与 在每个关键培训领域的国家专家，这个奖项将建立追求的条件， 通过保护候选人的时间不受临床责任的影响，在未来保持这项研究计划。 在短期内，该奖项将产生初步数据，为大型实用试验的设计提供信息， 将评估DTx在严重精神疾病患者戒烟中的公平传播。在 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 在戒毒治疗DTx中，公平实施和技术转让DTx的新模式 在种族/少数民族中，为不同的初级科学家提供指导机会， 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.