Financial Risks and Ethnic/Racial Disparities in Live Kidney Donation

描述（由申请人提供）：Tanjala S.珀内尔是二年级的博士约翰霍普金斯布隆伯格公共卫生学院卫生政策和管理系的学生和约翰霍普金斯韦尔奇预防、流行病学和临床研究中心的研究实习生。她寻求这个国家研究服务奖（NRSA）培训补助金，以支持她的职业发展，目标是成为一名成功的独立临床研究人员，研究如何解决慢性肾病患者的种族/种族健康差异。在此期间，珀内尔女士将在一个旨在为她未来的职业生涯提供坚实基础的计划中进行严格的研究和教学培训。在她的研究中，她将检查种族/种族差异的态度，对经济风险的活肾捐赠，确定是否种族/种族差异的态度与种族/种族差异的捐赠意愿，她将评估的影响联邦和州的政策干预措施，解决经济障碍，活肾捐赠率后种族/种族差异的活肾捐赠。此外，她将评估是否获得有利的资源（包括收入/财富，医疗保险和职业声望）解释种族/种族差异的关系，对经济风险的态度和种族/种族差异的捐赠意愿。为了实现这些目标，她将在美国进行活体肾脏捐赠态度和行为的横截面和纵向研究，利用从公众的区域和国家研究中获得的复杂加权调查数据，并通过创建活体肾脏捐赠者的国家数据集，利用来自多个来源的公开数据。她将在这些研究中采用回归分析，多时间序列分析和其他纵向分析技术。Purnell女士的研究目标与国家糖尿病、消化和肾脏疾病研究所的终末期肾脏疾病目标密切相关，重点是提高肾移植和捐赠率，特别是非洲裔美国人和其他少数民族/种族群体。在她的教学计划中，珀内尔女士将学习研究方法的高级课程，包括研究设计和分析，赠款写作和研究伦理的高级技术。通过参加国家会议以及在韦尔奇中心的支持性培训环境中举行的几次高级研究研讨会，她还将有机会观察他人的工作并介绍自己的工作。她已经确定了一个经验丰富的教师导师团队，他们致力于支持她的成功，并确保她有足够的资源来确保她完成本申请的拟议目标。公共卫生相关性：我的主要职业目标是成为一名成功的独立卫生服务和政策研究人员，其工作直接有助于改善健康结果，并减少慢性肾脏病患者在获取和质量方面的差异。我希望我未来的工作有助于实施联邦和州政策立法，改善慢性肾病患者的健康状况，并影响医疗保健决策，改善弱势群体的护理。我还计划通过追求学术生涯来激励和培训未来的卫生服务和政策研究人员。Kirschstein-NRSA奖学金培训奖将为我提供进一步发展我追求研究和职业目标所需技能的机会。这个奖项将使我能够专注于课程和体验式学习的机会，这将有助于我的论文工作的成功完成，以及我作为一个独立的卫生服务和政策研究人员的发展。除了课程之外，在奖学金期间，我的培训活动的一个重点是与约翰霍普金斯彭博公共卫生学院、约翰霍普金斯医学院、约翰霍普金斯健康差异解决中心和约翰霍普金斯韦尔奇预防、流行病学、以及与我的职业目标直接相关的项目的临床研究。

DESCRIPTION (provided by applicant): Tanjala S. Purnell is a second-year Ph.D. student in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and a research trainee at the Johns Hopkins Welch Center for Prevention, Epidemiology, and Clinical Research. She seeks this National Research Service Award (NRSA) Training Grant to support her career development with the goal of becoming a successful independent clinical researcher studying ways to address ethnic/racial health disparities for patients with chronic kidney disease. During this award, Ms. Purnell will pursue rigorous research and didactic training in a program designed to provide a strong foundation for her future career. In her research, she will examine ethnic/racial differences in attitudes regarding economic risks of live kidney donation, determine whether ethnic/racial differences in attitudes are associated with ethnic/race differences in willingness to donate, and she will assess the impact of federal and state policy interventions addressing economic barriers to live donation upon ethnic/racial differences in live kidney donation rates. Additionally, she will assess whether access to enabling resources (including income/wealth, health insurance, and occupational prestige) explain the relation of ethnic/race differences in attitudes toward economic risks and ethnic/race differences in willingness to donate. To accomplish these aims, she will conduct cross-sectional and longitudinal studies of living kidney donation attitudes and behaviors in the United States, utilizing complex weighted survey data obtained from regional and national studies of persons in the general public and by creating a national dataset of living kidney donors utilizing publicly available data from several sources. She will employ regression analyses, multiple-time series analyses, and other longitudinal analysis techniques in these studies. Ms. Purnell's research objectives are closely aligned with the National Institute of Diabetes and Digestive and Kidney Diseases end-stage renal disease target focus of improving rates of kidney transplantation and donation, particularly by African Americans and other ethnic/racial minority groups. In her didactic program, Ms. Purnell will take advanced coursework in research methods, including advanced techniques in study design and analysis, grant writing, and research ethics. Through attendance at national meetings as well as several advanced research seminars, held in the supportive training environment at the Welch Center, she will also have the opportunity to observe the work of others and present her own work. She has identified a team of experienced faculty mentors who are committed to supporting her success and who will make sure she has the resources to assure her completion of the proposed aims of this application. PUBLIC HEALTH RELEVANCE: My primary career goal is to become a successful independent health services and policy researcher whose work directly contributes to improving health outcomes and reducing disparities in measures of access and quality for patients with chronic kidney disease. I want my future work to contribute to the implementation of federal and state policy legislation that improves health outcomes for chronic kidney disease patients and influences healthcare decision-making that will improve delivery of care for vulnerable populations. I also plan to motivate and train future health services and policy researchers by pursuing a career in academia. The Kirschstein-NRSA Fellowship Training Award will provide me with the opportunity to further develop the skills I need to pursue my research and career goals. This award will allow me to concentrate on coursework and opportunities for experiential learning that will facilitate the successful completion of my dissertation work, as well as my development as an independent health services and policy researcher. In addition to the coursework, an integral focus of my training activities during the fellowship award period will be to engage in special studies and to participate in research projects with faculty members and researchers at the Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Medicine, Johns Hopkins Center for Health Disparities Solutions, and the Johns Hopkins Welch Center for Prevention, Epidemiology, and Clinical Research on projects directly related to my career goals.