1
|
Mehta S, Ahluwalia A, Ahluwalia A, Burns KEA, O'Hearn K, Maratta C, Menon K, Rochwerg B, Murthy S, Fowler R, Fiest KM. The Diversity of Research Participants in Randomized Controlled Trials and Observational Studies Conducted by the Canadian Critical Care Trials Group. Ann Am Thorac Soc 2024; 21:1309-1315. [PMID: 38889344 DOI: 10.1513/annalsats.202312-1074oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/13/2024] [Indexed: 06/20/2024] Open
Abstract
Rationale: Women, older individuals, and racial and ethnic minority groups are often underrepresented in research studies. Objectives: We evaluated the demographics and diversity of participants enrolled in randomized controlled trials (RCTs) and observational studies published by investigators in association with the Canadian Critical Care Trials Group. Methods: We performed quantitative content analysis of peer-reviewed RCTs and observational studies from December 1994 to December 2022. For each publication, we extracted participant demographic variables, including sex, gender, age, race or ethnicity, sexual orientation, pregnancy status, language proficiency, income/financial status, housing, education, disability, and geography. Results: A total of 120 publications (28 RCTs, 92 observational studies) included 211,144 enrolled participants. Most (107 of 120; 89.2%) were multicenter studies, and 70% (84 of 120) were conducted exclusively in Canadian centers; 77.5% (93 of 120) studies enrolled adult participants, and 19.2% (23 of 120) enrolled pediatric participants. All studies reported participant mean or median age, 118 (98.3%) reported binary sex or gender, and 9 (7.5%) reported race or ethnicity. No justification was provided in 35 studies that listed pregnancy as an exclusion. There was infrequent reporting of housing (n = 4), employment (n = 2), income (n = 2), and education (n = 1). No studies reported the language proficiency, sexual orientation, disability, or geography of participants. Of the studies reporting gender, women and/or girls comprised 42.3% participants (range, 8.9-67.7%). Within nine studies reporting race or ethnicity of 2,950 participants, 59.7% were White, 8% South Asian, 7% Indigenous, 3% Asian, 1% Black, 14% unknown, and 6% "other." Conclusions: Research publications from the Canadian Critical Care Trials Group infrequently report important participant demographics, and diversity of research participants is disproportionate compared with Canadian societal demographics.
Collapse
Affiliation(s)
- Sangeeta Mehta
- Department of Medicine, Sinai Health, Toronto, Ontario, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Arjan Ahluwalia
- University of Limerick School of Medicine, Limerick, Ireland
| | - Amrit Ahluwalia
- Department of Internal Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Katie O'Hearn
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Christina Maratta
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kusum Menon
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Bram Rochwerg
- Department of Medicine and
- Department of Health Research Methodology, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Srinivas Murthy
- Department of Paediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rob Fowler
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; and
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
2
|
Hughes ME, Garcia-Romeu A. Ethnoracial inclusion in clinical trials of psychedelics: a systematic review. EClinicalMedicine 2024; 74:102711. [PMID: 39050106 PMCID: PMC11268117 DOI: 10.1016/j.eclinm.2024.102711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
Background Prior data indicate limited ethnoracial diversity in studies testing psychedelic-assisted treatments. Regulatory approval for psychedelic treatments may be imminent given growing evidence for safety and efficacy in a variety of psychiatric conditions. Data on racial and ethnic inclusion rates in clinical psychedelic studies since 2018 have not been systematically reported to date. With the publication of multiple new studies in the field, an update to existing ethnoracial inclusion data is needed to inform the state of the science and future directions for research. Methods Systematic review of Pubmed/MEDLINE, EMBASE, and Web of Science for studies of any design testing a psychedelic treatment for a psychiatric or substance use disorder published between January 1, 1994 and May 24, 2024. Search terms related to serotonergic psychedelics and MDMA, psychedelic therapies, psychiatric disorders, and substance use disorders were used. References of reviewed studies were screened for inclusion. Studies were rated for quality on a five-point scale ranging from 1 (most rigorous, i.e., properly powered randomized clinical trial) to 5 (least rigorous, e.g., case reports). Separate analyses were performed for two groups of studies, one involving all included studies meeting search criteria, and the other involving only studies from the USA. Rates of inclusion of different ethnoracial groups were calculated between studies published before and after December 31, 2017. Additionally, the proportion of White vs. non-White participants was compared between studies published before and after December 31, 2017. Finally, a nonparametric Mann-Whitney U test was used to compare the relative quality ratings of studies published before and after December 31, 2017. Findings 787 studies were screened, and 39 studies were included. This included 16 studies (n = 282) from a prior review published in 2018 with an additional 23 studies (n = 1111) that were published after 2017, consisting of 14 randomized controlled studies, 8 open-label studies, and 1 placebo-controlled, within-subject, fixed-order study. In all included studies published after 2017, 85.6% of participants identified as non-Hispanic White, 3.1% as Black, 6.8% as Latinx/Hispanic, 3.6% as Asian, 1.2% as Indigenous, 3.5% as mixed race, 1.4% as other, Pooled data from all included studies (n = 1393) found 85.0% of participants identified as non-Hispanic White, 2.9% as Black, 5.9% as Latinx/Hispanic, 3.2% as Asian, 1.9% as Indigenous, 3.7% as mixed race, 1.4% as other. In studies conducted in the USA (n = 1074), 908 (84.5%) of participants identified as White, 36 (3.4%) as Black, 80 (7.4%) as Latinx/Hispanic, 43 (4.0%) as Asian, 15 (1.4%) as Indigenous, 40 (3.7%) as Mixed, and 9 (0.8%) as Other. Differences in inclusion rates were found when comparing studies published before and after December 31, 2017 for all included studies and all studies conducted in the USA. The proportion of White to non-White participants was found to have decreased in studies conducted in the USA over the same period, but not for all included studies. Interpretation Underrepresentation of ethnoracial minoritized populations persists in studies examining psychedelic therapies, despite growing calls for diversity. Non-Hispanic White participants remain an over-represented majority by a large margin, though, there were greater proportions of ethnic minoritized populations included in studies since 2018, particularly in studies conducted in the USA. This indicates progress towards equity in psychedelic research, though much work is needed to inform the safety and efficacy of psychedelic treatments in the general population. Funding There was no funding source for this study.
Collapse
Affiliation(s)
- Marcus E. Hughes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Interventional Psychiatry Service, Yale Psychiatric Hospital, New Haven, CT, USA
| | - Albert Garcia-Romeu
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
3
|
Verhoeven D, Siesling S, Allemani C, Roy PG, Travado L, Bhoo-Pathy N, Rhayns C, Junkermann H, Nakamura S, Lasebikan N, Tucker FL. High-value breast cancer care within resource limitations. Oncologist 2024; 29:e899-e909. [PMID: 38780115 PMCID: PMC11224985 DOI: 10.1093/oncolo/oyae080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 03/19/2024] [Indexed: 05/25/2024] Open
Abstract
Breast cancer care is a costly global health issue where effective management depends on early detection and treatment. A breast cancer diagnosis can result in financial catastrophe especially in low- and middle-income countries (LMIC). Large inequities in breast cancer care are observed and represent a global challenge to caregivers and patients. Strategies to improve early diagnosis include awareness and clinical breast examination in LMIC, and screening in high-income countries (HIC). The use of clinical guidelines for the management of breast cancer is needed. Adapted guidelines from HIC can address disparities in populations with limited resources. Locally developed strategies still provide effective guidance in improving survival. Integrated practice units (IPU) with timely multidisciplinary breast care conferences and patient navigators are required to achieve high-value, personalized breast cancer management in HIC as well as LMIC. Breast cancer patient care should include a quality of life evaluation using ideally patient-reported outcomes (PROM) and experience measurements (PREM). Evaluation of breast cancer outcomes must include the financial cost of delivered care. The resulting value perspective should guide resource allocation and program priorities. The value of care must be improved by translating the findings of social and economic research into practice and resolving systemic inequity in clinical breast cancer research. Cancer survivorship programs must be put in place everywhere. The treatment of patients with metastatic breast cancer must require more attention in the future, especially in LMIC.
Collapse
Affiliation(s)
- Didier Verhoeven
- Department of Medical Oncology, University of Antwerp, AZ KLINA, Brasschaat, Belgium
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pankaj Gupta Roy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Luzia Travado
- Champalimaud Clinical and Research Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Nirmala Bhoo-Pathy
- Department of Epidemiology, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Seigo Nakamura
- Division of Breast Surgical Oncology, Department of Surgery, Showa University, Tokyo, Japan
| | - Nwamaka Lasebikan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | |
Collapse
|
4
|
Amonoo HL, Khandai AC, Boardman AC, Ernst CL, Fernandez-Robles C, Suarez L, Bradley MV, Forrester AK, Dale C, Lee K, Vaughn R, Mittal LP. Annual Meeting Content Analysis: Leveraging Annual Meetings to Promote Diversity, Equity, Inclusion, and Belonging in the Academy of Consultation-Liaison Psychiatry. J Acad Consult Liaison Psychiatry 2024; 65:357-365. [PMID: 38395108 PMCID: PMC11339239 DOI: 10.1016/j.jaclp.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/07/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND There is an increasing need to promote diversity, equity, and inclusion (DEI) in all aspects of academic medicine, including through continuing medical education. Although professional medical organizations' annual meetings play an instrumental role in continuing medical education for physicians, there are no studies describing DEI content in the annual meeting programming of professional medical organizations, including the Academy of Consultation-Liaison Psychiatry (ACLP), the primary professional organization for consultation-liaison psychiatrists. OBJECTIVE To examine the ACLP annual meeting titles using Content Analysis. METHODS We examined the publicly available ACLP annual meeting content titles on the ACLP website from 2010 to 2021. National DEI leaders from ACLP's DEI subcommittee iteratively generated keywords that covered a broad scope of DEI-related themes. Each annual meeting's content was independently coded by 2 members of the DEI subcommittee with discrepancies adjudicated by 2 additional members. Descriptive statistics were used to characterize the content of the annual meeting. RESULTS Of the 2615 annual meeting titles from 2010 to 2021 that were analyzed, 2531 were not coded to have DEI themes. Three percent (n = 84) of titles were coded to have a DEI theme as follows: Culture/diversity (n = 20, 24%), bias/disparities (n = 17, 20%), race/racism (n = 17, 20%), social justice (n = 12, 14%), gender/sexism (n = 10, 12%), and LGBTQ+ (n = 8, 10%). The frequency of DEI titles each year ranged from 1% (2010, 2018) to 17% (2021) with an increase in DEI content in 2021 (n = 24, 17%). CONCLUSIONS Although professional medical organizations like the ACLP are poised to leverage their continuing medical education platforms embedded in annual meeting programming to train consultation-liaison psychiatrists on DEI topics, our findings suggest more work is needed to develop and promote DEI-focused educational programming for their annual meetings.
Collapse
Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Abhisek C Khandai
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Carrie L Ernst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carlos Fernandez-Robles
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Laura Suarez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Mark V Bradley
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY
| | - Anique K Forrester
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Ciara Dale
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
| | - Kewchang Lee
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA
| | - Rubiahna Vaughn
- Department of Psychiatry, Albert Einstein College of Medicine, New York, NY
| | - Leena P Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
| |
Collapse
|
5
|
Mallon WT, Cox N. Promotion and Tenure Policies and Practices at U.S. Medical Schools: Is Tenure Irrelevant or More Relevant Than Ever? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:724-732. [PMID: 38489477 DOI: 10.1097/acm.0000000000005689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
ABSTRACT Promotion and tenure (P&T) have been common mechanisms to support and nurture faculty at higher education institutions and, therefore, have been of continual interest to medical school faculty and administrators. In the last decade, significant changes in the academic medicine sector have occurred, including new medical schools, mergers and acquisitions of academic hospitals and health systems, and institutional and societal efforts to address systemic racism and inequality. In addition, societal controversies have revived long-dormant concerns about academic freedom for medical school faculty, a bedrock principle of U.S. higher education for more than a century. These developments raise the question of whether tenure at medical schools is increasingly irrelevant for large numbers of full-time faculty or more relevant than ever.Using a 2022 survey of 118 medical schools, a review of P&T policies at 37 other medical schools, and an analysis of Association of American Medical Colleges Faculty Roster data, the authors review the prevalence of tenure systems at U.S. MD-granting medical schools; trends in the use of such systems for full-time basic science and clinical faculty; models of including diversity, equity, and inclusion (DEI) criteria in P&T standards; and alterations to introduce greater flexibility into the P&T process.The authors' analysis shows that, although tenure systems remain well established at U.S. MD-granting medical schools, the percentage of full-time faculty on tenured or tenure-eligible tracks declined over the last 4 decades. Troubling gaps in tenure-eligible appointments persist between men and women faculty and among faculty by race and ethnicity. Medical schools have begun to deploy a variety of tactics in P&T processes focused on DEI to address these systemic inequities. To adapt the traditional tenure system to meet the needs of academic medicine, medical schools have altered their policies, including tenure financial guarantees, probationary period extensions, and post-tenure review.
Collapse
|
6
|
Ben-Arye E, Lopez AM, Daoud N, Zoller L, Walker E, Davidescu M, Shulman K, Gressel O, Stein N, Brosh S, Schiff E, Samuels N. Identifying Factors Associated With Disparities in Access to Integrative Oncology Program. J Pain Symptom Manage 2024; 68:10-21. [PMID: 38552747 DOI: 10.1016/j.jpainsymman.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/28/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
CONTEXT AND OBJECTIVES Cancer centers are increasingly providing complementary medicine as part of an emerging discipline termed 'integrative oncology' (IO). The present study explored factors associated with disparities in referral and adherence to a freely-provided IO program. METHODS The databases of three oncology centers in northern Israel were searched retrospectively for chemotherapy-treated oncology patients eligible for referral by their oncology healthcare professionals to an integrative physician (IP) consultation. Demographic and cancer-related variables associated with the referral, and attendance by patients at the consultation were identified, as was adherence to the 6-week IO treatment program (high adherence, attending ≥4 IO treatment sessions; low adherence, 0-3 sessions). RESULTS Of 4988 eligible patients, 1694 (34%) were referred to the IP consultation, with 1331 (78.6%) attending the consultation of which 766 (57.6%) were adherent to IO treatments. Multivariate analysis revealed lower referral rates among patients speaking primarily Arabic and Russian vs. Hebrew (OR = 3.0, 95% CI = 2.0-4.6, P < 0.0001); males vs. females (OR = 1.94, CI = 1.3-2.9, P = 0.001); those not reporting emotional distress (OR = 1.5, CI = 1.02-2.16, P = 0.037); and older age (OR = 1.04, CI = 1.03-1.06, P < 0.0001). Arabic and Russian-speaking patients were less likely to adhere to IO treatments (OR = 0.52, 95% CI = 0.32-0.83, P = 0.006). CONCLUSION Patients' ethno-national origin and immigration status (primary language, Arabic and Russian), male gender and older age were associated with lower rates of referral to and attendance of the IP consultation, with reduced adherence to weekly IO treatments. These findings require further study to identify barriers toward diversity, equity and inclusion in IO care, increasing awareness among healthcare professionals regarding the benefits of these services for improving patient wellbeing.
Collapse
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program (E.B.A., M.D.), The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel; Rappaport Faculty of Medicine (E.B.A., K.S., E.S.), Technion-Israel Institute of Technology, Haifa, Israel.
| | - Ana Maria Lopez
- Sidney Kimmel Medical College and Sidney Kimmel Cancer Center (A.M.L.), Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nihaya Daoud
- School of Public health, Faculty of Health Sciences (N.D.), Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Lilach Zoller
- Haifa and Western Galilee District (L.Z.), Clalit Health Services, Haifa, Israel
| | | | - Michal Davidescu
- Integrative Oncology Program (E.B.A., M.D.), The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
| | - Katerina Shulman
- Rappaport Faculty of Medicine (E.B.A., K.S., E.S.), Technion-Israel Institute of Technology, Haifa, Israel; The Oncology Service (K.S.), Lin and Zebulun Medical Centers, Clalit Health Services, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program (E.B.A., M.D.), The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology (N.S.), Carmel Medical Center, Haifa, Israel
| | | | - Elad Schiff
- Rappaport Faculty of Medicine (E.B.A., K.S., E.S.), Technion-Israel Institute of Technology, Haifa, Israel; Department of Internal Medicine & Integrative Medicine Service (E.S.), Bnai-Zion, hospital, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine (N.S.), Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
7
|
Ezell JM. The Health Disparities Research Industrial Complex: Remastered. Soc Sci Med 2024; 351:116947. [PMID: 38763799 DOI: 10.1016/j.socscimed.2024.116947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 05/03/2024] [Indexed: 05/21/2024]
Affiliation(s)
- Jerel M Ezell
- Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
| |
Collapse
|
8
|
Harvey RD, Miller TM, Hurley PA, Thota R, Black LJ, Bruinooge SS, Boehmer LM, Fleury ME, Kamboj J, Rizvi MA, Symington BE, Tap WD, Waterhouse DM, Levit LA, Merrill JK, Prindiville SA, Pollastro T, Brewer JR, Byatt LP, Hamroun L, Kim ES, Holland N, Nowakowski GS. A call to action to advance patient-focused and decentralized clinical trials. Cancer 2024; 130:1193-1203. [PMID: 38193828 DOI: 10.1002/cncr.35145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
This commentary is a call to action for a concerted commitment and effort to transform clinical trials and enable people with cancer to participate in clinical trials closer to home. Three key strategies are identified to address major barriers: confront challenges with the interpretation of US Food and Drug Administration Form 1572 requirements (Statement of Investigator); broaden acceptance of local laboratories and imaging centers; and invest in the creation of effective, sustainable partnerships between research centers and local providers.
Collapse
Affiliation(s)
- R Donald Harvey
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Therica M Miller
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA
| | | | - Ramya Thota
- Intermountain Health, Salt Lake City, Utah, USA
| | | | | | - Leigh M Boehmer
- Association of Community Cancer Centers, Rockville, Maryland, USA
| | - Mark E Fleury
- American Cancer Society Cancer Action Network, Washington, District of Columbia, USA
| | | | | | | | - William D Tap
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Laura A Levit
- American Society of Clinical Oncology, Alexandria, Virginia, USA
| | | | - Sheila A Prindiville
- National Cancer Institute Coordinating Center for Clinical Trials, Bethesda, Maryland, USA
| | - Teri Pollastro
- Metastatic Breast Cancer Alliance, Mercer Island, Washington, USA
| | - Jamie R Brewer
- US Food and Drug Administration, Rockville, Maryland, USA
| | - Leslie P Byatt
- New Mexico Cancer Care Alliance, Albuquerque, New Mexico, USA
| | | | | | - Nicole Holland
- American Society of Clinical Oncology, Alexandria, Virginia, USA
| | | |
Collapse
|
9
|
Sprague Martinez L, Araujo Brinkerhoff C, Howard RC, Feldman JA, Kobetz E, White JT, Tumiel Berhalter L, Bilheimer A, Hoffman M, Isasi CR, Killough C, Martinez J, Chesley J, Baig AA, Foy C, Islam N, Petruse A, Rosales C, Kipke MD, Baezconde-Garbanati L, Battaglia TA, Lobb R. Strategies to promote language inclusion at 17 CTSA hubs. J Clin Transl Sci 2024; 8:e67. [PMID: 38690228 PMCID: PMC11058578 DOI: 10.1017/cts.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 05/02/2024] Open
Abstract
The prioritization of English language in clinical research is a barrier to translational science. We explored promising practices to advance the inclusion of people who speak languages other than English in research conducted within and supported by NIH Clinical Translational Science Award (CTSA) hubs. Key informant interviews were conducted with representatives (n = 24) from CTSA hubs (n = 17). Purposive sampling was used to identify CTSA hubs focused on language inclusion. Hubs electing to participate were interviewed via Zoom. Thematic analysis was performed to analyze interview transcripts. We report on strategies employed by hubs to advance linguistic inclusion and influence institutional change that were identified. Strategies ranged from translations, development of culturally relevant materials and consultations to policies and procedural changes and workforce initiatives. An existing framework was adapted to conceptualize hub strategies. Language justice is paramount to bringing more effective treatments to all people more quickly. Inclusion will require institutional transformation and CTSA hubs are well positioned to catalyze change.
Collapse
Affiliation(s)
- Linda Sprague Martinez
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| | - Cristina Araujo Brinkerhoff
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| | - Riana C. Howard
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| | - James A. Feldman
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
- Boston Medical Center Health System, Boston, MA, USA
| | - Erin Kobetz
- University of Miami Clinical and Translational Science Institute, Miami, FL, USA
| | - J. Tommy White
- North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Laurene Tumiel Berhalter
- Dept of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- University at Buffalo Clinical and Translational Science Institute, Buffalo, NY, USA
| | - Alicia Bilheimer
- North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Megan Hoffman
- University of Minnesota Clinical and Translational Science Institute, Minneapolis, MN, USA
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
- The Harold and Muriel Block Institute for Clinical and Translational Research (ICTR), New York, NY, USA
| | - Cynthia Killough
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Julia Martinez
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | | | - Arshiya A. Baig
- Department of Medicine, University of Chicago Center for Institute for Clinical and Translational Science, University of Chicago, Chicago, IL, USA
| | - Capri Foy
- Wake Forrest University School of Medicine Clinical and Translational Science Institute, Winston-Salem, NC, USA
| | - Nadia Islam
- New York Langone University Clinical and Translational Science Institute, New York, NY, USA
| | - Antonia Petruse
- Clinical and Translational Science Institute Office of Clinical Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Carolina Rosales
- University of Florida Clinical and Translational Science Institute, Gainesville, FL, USA
| | - Michele D. Kipke
- Southern California Clinical and Translational Science Institute (SC CTSI), Los Angeles, CA, USA
| | | | - Tracy A. Battaglia
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
- Boston Medical Center Health System, Boston, MA, USA
| | - Rebecca Lobb
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| |
Collapse
|
10
|
Villablanca A, Dugger BN, Nuthikattu S, Chauhan J, Cheung S, Chuah CN, Garrison SL, Milenkovic D, Norman JE, Oliveira LC, Smith BP, Brown SD. How cy pres promotes transdisciplinary convergence science: an academic health center for women's cardiovascular and brain health. J Clin Transl Sci 2024; 8:e16. [PMID: 38384925 PMCID: PMC10880003 DOI: 10.1017/cts.2023.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 02/23/2024] Open
Abstract
Cardiovascular disease (CVD) is largely preventable, and the leading cause of death for men and women. Though women have increased life expectancy compared to men, there are marked sex disparities in prevalence and risk of CVD-associated mortality and dementia. Yet, the basis for these and female-male differences is not completely understood. It is increasingly recognized that heart and brain health represent a lifetime of exposures to shared risk factors (including obesity, hyperlipidemia, diabetes, and hypertension) that compromise cerebrovascular health. We describe the process and resources for establishing a new research Center for Women's Cardiovascular and Brain Health at the University of California, Davis as a model for: (1) use of the cy pres principle for funding science to improve health; (2) transdisciplinary collaboration to leapfrog progress in a convergence science approach that acknowledges and addresses social determinants of health; and (3) training the next generation of diverse researchers. This may serve as a blueprint for future Centers in academic health institutions, as the cy pres mechanism for funding research is a unique mechanism to leverage residual legal settlement funds to catalyze the pace of scientific discovery, maximize innovation, and promote health equity in addressing society's most vexing health problems.
Collapse
Affiliation(s)
- Amparo Villablanca
- Department of Internal Medicine, University of California, Davis, CA, USA
| | - Brittany N. Dugger
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, USA
| | | | - Joohi Chauhan
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, USA
- Department of Computer Engineering, University of California, Davis, CA, USA
| | - Samson Cheung
- Department of Computer Engineering, University of California, Davis, CA, USA
| | - Chen-Nee Chuah
- Department of Computer Engineering, University of California, Davis, CA, USA
| | - Siedah L. Garrison
- Department of Internal Medicine, University of California, Davis, CA, USA
| | | | - Jennifer E. Norman
- Department of Internal Medicine, University of California, Davis, CA, USA
| | - Luca Cerny Oliveira
- Department of Computer Engineering, University of California, Davis, CA, USA
| | - Bridgette P. Smith
- Department of Internal Medicine, University of California, Davis, CA, USA
| | - Susan D. Brown
- Department of Internal Medicine, University of California, Davis, CA, USA
| |
Collapse
|
11
|
Chen KL, Oronce CIA, Calderón NE, Kahn KL. Academic seminars as tool for clinical and translational science education and dissemination: Perceptions and priorities in the COVID-19 era. Clin Transl Sci 2024; 17:e13680. [PMID: 37983955 PMCID: PMC10766022 DOI: 10.1111/cts.13680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/26/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023] Open
Abstract
Academic seminars are an important venue through which investigators in health services research (HSR) and other clinical and translational science disciplines can share their work, gather feedback, and connect with colleagues. However, the format and focus of these seminars shifted abruptly when the coronavirus disease 2019 (COVID-19) pandemic necessitated social distancing and underscored the salience of health equity. Little is known about how contemporary academic seminars are meeting the evolving needs of the HSR community. We surveyed 2021-2022 participants in a virtual HSR seminar series to understand experiences of and priorities for the seminars. We also compared results stratified by self-reported under-represented minority (URM) status. Of 45 respondents (including 26 faculty members, 8 trainees, 9 staff members, and 2 community partners), 38% self-identified as URM. Participants reported high satisfaction with seminar quality, diversity of topics, and audience participation (median ≥4 for all outcomes in Likert-scaled items where 5 = very satisfied). Knowledge acquisition, understanding of research methods, and collaboration were commonly cited as benefits of seminar attendance. Implementation science content and external collaboration were most often endorsed as priorities for future seminars. URM participants were over three times more likely than non-URM participants to cite learning about engaging community stakeholders and historically excluded populations as a benefit of seminar participation. Virtual academic seminars can be an effective modality for knowledge sharing and collaboration worth continuing after COVID-19 restrictions are lifted. Emphasizing equity, diversity, and inclusion (EDI) values in these seminars may hold potential for advancing academic departments' own EDI goals.
Collapse
Affiliation(s)
- Katherine L. Chen
- Division of General Internal Medicine & Health Services Research, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Carlos Irwin A. Oronce
- Division of General Internal Medicine & Health Services Research, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
- Department of MedicineVA Greater Los Angeles Healthcare System, CaliforniaLos AngelesCaliforniaUSA
| | | | - Katherine L. Kahn
- Division of General Internal Medicine & Health Services Research, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| |
Collapse
|
12
|
Samuels E, Janevic MR, Harper AE, Lyden AK, Jay GM, Champagne E, Murphy SL. Updating and evaluating a research best practices training course for social and behavioral research professionals. J Clin Transl Sci 2023; 8:e12. [PMID: 38384926 PMCID: PMC10877512 DOI: 10.1017/cts.2023.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 02/23/2024] Open
Abstract
Introduction The clinical and translational research workforce involved in social and behavioral research (SBR) needs to keep pace with clinical research guidance and regulations. Updated information and a new module on community and stakeholder engagement were added to an existing SBR training course. This article presents evaluation findings of the updated course for the Social and Behavioral Workforce. Methods and Materials Participants working across one university were recruited. Course completers were sent an online survey to evaluate the training. Some participants were invited to join in a focus group to discuss the application of the training to their work. We performed descriptive statistics and conducted a qualitative analysis on focus group data. Results There were 99 participants from diverse backgrounds who completed the survey. Most reported the training was relevant to their work or that of the study teams they worked with. Almost half (46%) indicated they would work differently after participating. Respondents with community or stakeholder engaged research experience vs. those without were more likely to report that the new module was relevant to study teams they worked with (t = 5.61, p = 0.001), and that they would work differently following the training (t = 2.63, p = 0.01). Open-ended survey responses (n = 99) and focus group (n = 12) data showed how participants felt their work would be affected by the training. Conclusion The updated course was rated highly, particularly by those whose work was related to the new course content. This course provides an up-to-date resource for the training and development for the Social and Behavioral Workforce.
Collapse
Affiliation(s)
- Elias Samuels
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
| | - Mary R. Janevic
- Department of Health Behavior and Health Education, School of
Public Health, University of Michigan, Ann Arbor,
MI, USA
- Department of Physical Medicine and Rehabilitation,
University of Michigan, Ann Arbor,
MI, USA
| | - Alexandra E. Harper
- Department of Physical Medicine and Rehabilitation,
University of Michigan, Ann Arbor,
MI, USA
| | - Angela K. Lyden
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
- Clinical Trials Support Office, University of
Michigan, Ann Arbor, MI, USA
| | - Gina M. Jay
- Department of Physical Medicine and Rehabilitation,
University of Michigan, Ann Arbor,
MI, USA
| | - Ellen Champagne
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
| | - Susan L. Murphy
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
- Department of Health Behavior and Health Education, School of
Public Health, University of Michigan, Ann Arbor,
MI, USA
| |
Collapse
|
13
|
Kao J, Sahagian M, Gupta V, Missios S, Sangal A. Long-term disease-free survival following comprehensive involved site radiotherapy for oligometastases. Front Oncol 2023; 13:1267626. [PMID: 38144534 PMCID: PMC10739409 DOI: 10.3389/fonc.2023.1267626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/10/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Despite recent advances in drug development, durable complete remissions with systemic therapy alone for metastatic cancers remain infrequent. With the development of advanced radiation technologies capable of selectively sparing normal tissues, patients with oligometastases are often amenable to comprehensive involved site radiotherapy with curative intent. This study reports the long-term outcomes and patterns of failure for patients treated with total metastatic ablation often in combination with systemic therapy. Materials and methods Consecutive adult patients with oligometastases from solid tumor malignancy treated by a single high volume radiation oncologist between 2014 and 2021 were retrospectively analyzed. Oligometastases were defined as 5 or fewer metastatic lesions where all sites of active disease are amenable to local treatment. Comprehensive involved site radiotherapy consisted of stereotactic radiotherapy to a median dose of 27 Gy in 3 fractions and intensity modulated radiation therapy to a median dose of 50 Gy in 15 fractions. This study analyzed overall survival, progression-free survival, patterns of failure and toxicity. Results A total of 130 patients with 209 treated distant metastases were treated with a median follow-up of 36 months. The 4-year overall survival, progression-free survival, local control and distant control was 41%, 23%, 86% and 29%. Patterns of failure include 23% alive and free of disease (NED), 52% distant failure only, 9% NED but death from comorbid illness, 7% both local and distant failure, 4% NED but lost to follow-up, 4% referred to hospice before restaging, 1% local only failure, 1% alive with second primary cancer. Late grade 3+ toxicities occurred in 4% of patients, most commonly radionecrosis. Conclusion Involved site radiotherapy to all areas of known disease can safely achieve durable complete remissions in patients with oligometastases treated in the real world setting. Distant failures account for the majority of treatment failures and isolated local failures are exceedingly uncommon. Oligometastases represents a promising setting to investigate novel therapeutics targeting minimal residual disease.
Collapse
Affiliation(s)
- Johnny Kao
- Department of Radiation Oncology, Good Samaritan University Hospital, West Islip, West Islip, NY, United States
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, United States
- Cancer Institute, Good Samaritan University Hospital, West Islip, NY, United States
| | - Michelle Sahagian
- Department of Radiation Oncology, Good Samaritan University Hospital, West Islip, West Islip, NY, United States
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, United States
| | - Vani Gupta
- Department of Radiation Oncology, Good Samaritan University Hospital, West Islip, West Islip, NY, United States
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, United States
| | - Symeon Missios
- Cancer Institute, Good Samaritan University Hospital, West Islip, NY, United States
- Long Island Brain and Spine, West Islip, NY, United States
| | - Ashish Sangal
- Cancer Institute, Good Samaritan University Hospital, West Islip, NY, United States
| |
Collapse
|
14
|
Wilkins CH, Miller ST, Richmond AN, Carrasquillo O. Community-Engaged Research - Essential to Addressing Health Inequities. N Engl J Med 2023; 389:1928-1931. [PMID: 37982404 PMCID: PMC11088953 DOI: 10.1056/nejmp2307774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Consuelo H. Wilkins
- Office of Health Equity and Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | | | - Olveen Carrasquillo
- Division of General Internal Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
| |
Collapse
|
15
|
Roy AM, George A, Attwood K, Alaklabi S, Patel A, Omilian AR, Yao S, Gandhi S. Effect of neighborhood deprivation index on breast cancer survival in the United States. Breast Cancer Res Treat 2023; 202:139-153. [PMID: 37542631 PMCID: PMC10504126 DOI: 10.1007/s10549-023-07053-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To analyze the association between the Neighborhood Deprivation Index (NDI) and clinical outcomes of locoregional breast cancer (BC). METHODS Surveillance, Epidemiology and End Results (SEER) database is queried to evaluate overall survival (OS) and disease-specific survival (DSS) of early- stage BC patients diagnosed between 2010 and 2016. Cox multivariate regression was performed to measure the association between NDI (Quintiles corresponding to most deprivation (Q1), above average deprivation (Q2), average deprivation (Q3), below average deprivation (Q4), least deprivation (Q5)) and OS/DSS. RESULTS Of the 88,572 locoregional BC patients, 27.4% (n = 24,307) were in the Q1 quintile, 26.5% (n = 23,447) were in the Q3 quintile, 17% (n = 15,035) were in the Q2 quintile, 13.5% (n = 11,945) were in the Q4 quintile, and 15.6% (n = 13,838) were in the Q5 quintile. There was a predominance of racial minorities in the Q1 and Q2 quintiles with Black women being 13-15% and Hispanic women being 15% compared to only 8% Black women and 6% Hispanic women in the Q5 quintile (p < 0.001). In multivariate analysis, in the overall cohort, those who live in Q2 and Q1 quintile have inferior OS and DSS compared to those who live in Q5 quintile (OS:- Q2: Hazard Ratio (HR) 1.28, Q1: HR 1.2; DSS:- Q2: HR 1.33, Q1: HR 1.25, all p < 0.001). CONCLUSION Locoregional BC patients from areas with worse NDI have poor OS and DSS. Investments to improve the socioeconomic status of areas with high deprivation may help to reduce healthcare disparities and improve breast cancer outcomes.
Collapse
Affiliation(s)
- Arya Mariam Roy
- Division of Hematology and Oncology, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263 USA
| | - Anthony George
- Department of Biostatistics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14228 USA
| | - Kristopher Attwood
- Department of Biostatistics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14228 USA
| | - Sabah Alaklabi
- Division of Oncology, Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Archit Patel
- Division of Hematology and Oncology, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263 USA
| | - Angela R. Omilian
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14228 USA
| | - Song Yao
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14228 USA
| | - Shipra Gandhi
- Division of Hematology and Oncology, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263 USA
| |
Collapse
|
16
|
O'Leary ME, White M, Nihouarn Sigurdardottir J, Scott H, Jaramillo-Ospina AM, Bake S, Connor KL. Building strong health and career trajectories through translational research. J Dev Orig Health Dis 2023; 14:570-575. [PMID: 37830369 DOI: 10.1017/s2040174423000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Translational research (TR) is the movement of fundamental scientific discoveries into healthcare settings and population health policy, and parallels the goals of DOHaD research. Unfortunately, there is little guidance on how to become a translational researcher. To understand the opinions of DOHaD trainees towards TR, we conducted a workshop at the DOHaD World Congress 2022. We found that trainees were enthusiastic for their work to have translational impact, and that they feel that holistic, multidisciplinary solutions may lead to more generalisable research. However, there lacks support for TR career pathways, which may stall the execution of the long-term vision of the DOHaD agenda. We put forward recommendations for trainees to clarify their purpose in pursuing TR and for seeking relevant people and patronages to support their training paths. For mentors, training institutions, and scientific societies, we recommend developing TR-specific programmes, and implementing training opportunities, networking events, and funding to support these endeavours.
Collapse
Affiliation(s)
- M Elizabeth O'Leary
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Canada
| | - Marina White
- Department of Health Sciences, Carleton University, Ottawa, Canada
| | - Julie Nihouarn Sigurdardottir
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Hailey Scott
- Department of Health Sciences, Carleton University, Ottawa, Canada
| | | | - Shameena Bake
- Department of Neuroscience and Experimental Therapeutics, School of Medicine, Texas A&M University, Bryan, USA
| | - Kristin L Connor
- Department of Health Sciences, Carleton University, Ottawa, Canada
| |
Collapse
|
17
|
Vogel AL, Haynes BM, Hussain SF, Akacem LD, Hodges MG, Duberman JA, Butera G, Faupel‐Badger JM. Areas of strength and opportunities for growth in translational science education and training: Results of a scoping review from the NCATS Education Branch. Clin Transl Sci 2023; 16:1526-1546. [PMID: 37533169 PMCID: PMC10499424 DOI: 10.1111/cts.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 08/04/2023] Open
Abstract
Translational science education and training (E&T) aims to prepare the translational workforce to accelerate progress along the translational pipeline toward solutions that improve human health. In 2020-2021, the National Center for Advancing Translational Sciences (NCATS) Education Branch conducted a scoping review of the E&T literature with this focus. The review used the methodological framework proposed by Arksey and O'Malley. PubMed, Education Resources Information Center (ERIC), and Embase were searched, and forward citations conducted. Screening of titles, abstracts, and full text identified 44 included articles. Data extraction facilitated analysis of E&T content, audiences, modalities, evaluations, and recommendations. The NCATS Translational Science Principles were used to identity described or recommended E&T content. Twenty-nine articles described a translational science E&T opportunity or its evaluation, and another 15 articles offered recommendations for translational science E&T. The most prevalent NCATS Translational Science Principles were boundary-crossing partnerships (77%) and cross-disciplinary team science (75%). Among publications describing E&T opportunities, the most reported modalities were experiential learning (64%) and courses (61%) and the most reported participants were graduate students (68%) and postdoctoral fellows (54%). About half of these articles (n = 15) reported an evaluation, covering a range of proximal to distal outcomes. Recommendations emphasized the value of translational science E&T across training and career stages and the use of varied modalities to reach diverse audiences. This review highlights strengths and opportunities for growth in translational science E&T. Enhancements to content, expansion of participants and modalities, and rigorous evaluations will contribute to building a highly qualified, diverse translational science workforce.
Collapse
Affiliation(s)
- Amanda L. Vogel
- Education Branch, Office of Policy Communications and EducationNational Center for Advancing Translational Sciences, National Institutes of HealthBethesdaMarylandUSA
| | - Brittany M. Haynes
- Education Branch, Office of Policy Communications and EducationNational Center for Advancing Translational Sciences, National Institutes of HealthBethesdaMarylandUSA
| | - Shadab F. Hussain
- Education Branch, Office of Policy Communications and EducationNational Center for Advancing Translational Sciences, National Institutes of HealthBethesdaMarylandUSA
| | - Lameese D. Akacem
- Education Branch, Office of Policy Communications and EducationNational Center for Advancing Translational Sciences, National Institutes of HealthBethesdaMarylandUSA
| | - Marcus G. Hodges
- Education Branch, Office of Policy Communications and EducationNational Center for Advancing Translational Sciences, National Institutes of HealthBethesdaMarylandUSA
| | - Josh A. Duberman
- National Institutes of Health Library, Office of Research ServicesNational Institutes of HealthBethesdaMarylandUSA
| | - Gisela Butera
- National Institutes of Health Library, Office of Research ServicesNational Institutes of HealthBethesdaMarylandUSA
| | - Jessica M. Faupel‐Badger
- Education Branch, Office of Policy Communications and EducationNational Center for Advancing Translational Sciences, National Institutes of HealthBethesdaMarylandUSA
| |
Collapse
|
18
|
Davis MA, Lim N, Jordan J, Yee J, Gichoya JW, Lee R. Imaging Artificial Intelligence: A Framework for Radiologists to Address Health Equity, From the AJR Special Series on DEI. AJR Am J Roentgenol 2023; 221:302-308. [PMID: 37095660 DOI: 10.2214/ajr.22.28802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Artificial intelligence (AI) holds promise for helping patients access new and individualized health care pathways while increasing efficiencies for health care practitioners. Radiology has been at the forefront of this technology in medicine; many radiology practices are implementing and trialing AI-focused products. AI also holds great promise for reducing health disparities and promoting health equity. Radiology is ideally positioned to help reduce disparities given its central and critical role in patient care. The purposes of this article are to discuss the potential benefits and pitfalls of deploying AI algorithms in radiology, specifically highlighting the impact of AI on health equity; to explore ways to mitigate drivers of inequity; and to enhance pathways for creating better health care for all individuals, centering on a practical framework that helps radiologists address health equity during deployment of new tools.
Collapse
Affiliation(s)
- Melissa A Davis
- Department of Diagnostic Radiology, Yale University School of Medicine, 789 Howard Ave, PO Box 20842, New Haven, CT 06520
| | | | - John Jordan
- Stanford University School of Medicine, Stanford, CA
| | - Judy Yee
- Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY
| | | | - Ryan Lee
- Jefferson Health, Philadelphia, PA
| |
Collapse
|
19
|
Hawkes EA, Trotman J, Casulo C, Smith SM, LaCasce A. Author gender representation of journal reviews and editorials on lymphoma (2017-22). Lancet 2023; 402:523-525. [PMID: 37573074 DOI: 10.1016/s0140-6736(23)01428-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/14/2023]
Affiliation(s)
- Eliza A Hawkes
- Olivia Newton-John Cancer Research & Wellness Centre, Austin Health, Melbourne, VIC 3084, Australia; Monash University School of Public Health & Preventive Medicine, Melbourne, VIC, Australia.
| | - Judith Trotman
- Concord Repatriation Hospital, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia
| | - Carla Casulo
- Department of Medicine, University of Rochester, Rochester, NY, USA
| | - Sonali M Smith
- Department of Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, IL, USA
| | - Ann LaCasce
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| |
Collapse
|
20
|
Berkowitz SA, Basu S, Hanmer J. Eliminating Food Insecurity in the USA: a Target Trial Emulation Using Observational Data to Estimate Effects on Health-Related Quality of Life. J Gen Intern Med 2023; 38:2308-2317. [PMID: 36814050 PMCID: PMC10406772 DOI: 10.1007/s11606-023-08095-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Food insecurity is associated with many aspects of poor health. However, trials of food insecurity interventions typically focus on outcomes of interest to funders, such as healthcare use, cost, or clinical performance metrics, rather than quality of life outcomes that may be prioritized by individuals who experience food insecurity. OBJECTIVE To emulate a trial of a food insecurity elimination intervention, and quantify its estimated effects on health utility, health-related quality of life, and mental health. DESIGN Target trial emulation using longitudinal, nationally representative data, from the USA, 2016-2017. PARTICIPANTS A total of 2013 adults in the Medical Expenditure Panel Survey screened positive for food insecurity, representing 32 million individuals. MAIN MEASURES Food insecurity was assessed using the Adult Food Security Survey Module. The primary outcome was the SF-6D (Short-Form Six Dimension) measure of health utility. Secondary outcomes were mental component score (MCS) and physical component score (PCS) of the Veterans RAND 12-Item Health Survey (a measure of health-related quality of life), Kessler 6 (K6) psychological distress, and Patient Health Questionnaire 2-item (PHQ2) depressive symptoms. KEY RESULTS We estimated that food insecurity elimination would improve health utility by 80 QALYs per 100,000 person-years, or 0.008 QALYs per person per year (95% CI 0.002 to 0.014, p = 0.005), relative to the status quo. We also estimated that food insecurity elimination would improve mental health (difference in MCS [95% CI]: 0.55 [0.14 to 0.96]), physical health (difference in PCS: 0.44 [0.06 to 0.82]), psychological distress (difference in K6: -0.30 [-0.51 to -0.09]), and depressive symptoms (difference in PHQ-2: -0.13 [-0.20 to -0.07]). CONCLUSIONS Food insecurity elimination may improve important, but understudied, aspects of health. Evaluations of food insecurity interventions should holistically investigate their potential to improve many different aspects of health.
Collapse
Affiliation(s)
- Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Sanjay Basu
- Research and Development, Waymark, San Francisco, CA, USA
| | - Janel Hanmer
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
21
|
Velez MA, Glenn BA, Garcia-Jimenez M, Cummings AL, Lisberg A, Nañez A, Radwan Y, Lind-Lebuffe JP, Brodrick PM, Li DY, Fernandez-Turizo MJ, Gower A, Lindenbaum M, Hegde M, Brook J, Grogan T, Elashoff D, Teitell MA, Garon EB. Consent document translation expense hinders inclusive clinical trial enrolment. Nature 2023; 620:855-862. [PMID: 37532930 PMCID: PMC11046417 DOI: 10.1038/s41586-023-06382-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/28/2023] [Indexed: 08/04/2023]
Abstract
Patients from historically under-represented racial and ethnic groups are enrolled in cancer clinical trials at disproportionately low rates in the USA1-3. As these patients often have limited English proficiency4-7, we hypothesized that one barrier to their inclusion is the cost to investigators of translating consent documents. To test this hypothesis, we evaluated more than 12,000 consent events at a large cancer centre and assessed whether patients requiring translated consent documents would sign consent documents less frequently in studies lacking industry sponsorship (for which the principal investigator pays the translation costs) than for industry-sponsored studies (for which the translation costs are covered by the sponsor). Here we show that the proportion of consent events for patients with limited English proficiency in studies not sponsored by industry was approximately half of that seen in industry-sponsored studies. We also show that among those signing consent documents, the proportion of consent documents translated into the patient's primary language in studies without industry sponsorship was approximately half of that seen in industry-sponsored studies. The results suggest that the cost of consent document translation in trials not sponsored by industry could be a potentially modifiable barrier to the inclusion of patients with limited English proficiency.
Collapse
Affiliation(s)
- Maria A Velez
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Beth A Glenn
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Center for Cancer Prevention and Control Research, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Kaiser Permanente Center for Health Equity, University of Califonia, Los Angeles, Los Angeles, CA, USA
| | - Maria Garcia-Jimenez
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Division of Hematology/Oncology, UCLA-Olive View Medical Center, Los Angeles, CA, USA
| | - Amy L Cummings
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Aaron Lisberg
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrea Nañez
- Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yazeed Radwan
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jackson P Lind-Lebuffe
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paige M Brodrick
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Debory Y Li
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Arjan Gower
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Maggie Lindenbaum
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Manavi Hegde
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jenny Brook
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tristan Grogan
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA
| | - David Elashoff
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael A Teitell
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Edward B Garon
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA.
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA.
| |
Collapse
|
22
|
Clayton EW, Smith ME, Anderson KC, Chung WK, Connolly JJ, Fullerton SM, McGowan ML, Peterson JF, Prows CA, Sabatello M, Holm IA. Studying the impact of translational genomic research: Lessons from eMERGE. Am J Hum Genet 2023; 110:1021-1033. [PMID: 37343562 PMCID: PMC10357472 DOI: 10.1016/j.ajhg.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
Two major goals of the Electronic Medical Record and Genomics (eMERGE) Network are to learn how best to return research results to patient/participants and the clinicians who care for them and also to assess the impact of placing these results in clinical care. Yet since its inception, the Network has confronted a host of challenges in achieving these goals, many of which had ethical, legal, or social implications (ELSIs) that required consideration. Here, we share impediments we encountered in recruiting participants, returning results, and assessing their impact, all of which affected our ability to achieve the goals of eMERGE, as well as the steps we took to attempt to address these obstacles. We divide the domains in which we experienced challenges into four broad categories: (1) study design, including recruitment of more diverse groups; (2) consent; (3) returning results to participants and their health care providers (HCPs); and (4) assessment of follow-up care of participants and measuring the impact of research on participants and their families. Since most phases of eMERGE have included children as well as adults, we also address the particular ELSI posed by including pediatric populations in this research. We make specific suggestions for improving translational genomic research to ensure that future projects can effectively return results and assess their impact on patient/participants and providers if the goals of genomic-informed medicine are to be achieved.
Collapse
Affiliation(s)
- Ellen Wright Clayton
- Center for Biomedical Ethics and Society, Departments of Pediatrics and Health Policy, Vanderbilt University Medical Center, Nashville, TN 37203, USA.
| | - Maureen E Smith
- Department of Medicine, Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Katherine C Anderson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY 10032, USA
| | - John J Connolly
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Stephanie M Fullerton
- Department of Bioethics & Humanities, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Michelle L McGowan
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA; Department of Women's, Gender, and Sexuality Studies, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Josh F Peterson
- Center for Precision Medicine, Department of Biomedical Informatics, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Cynthia A Prows
- Divisions of Human Genetics and Patient Services, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA
| | - Maya Sabatello
- Center for Precision Medicine & Genomics, Department of Medicine, and Division of Ethics, Department of Medical Humanities & Ethics Columbia University Vagelos College of Physicians and Surgeons, NY, NY 10032, USA
| | - Ingrid A Holm
- Division of Genetics and Genomics, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
23
|
Bøttern J, Stage TB, Dunvald AD. Sex, racial, and ethnic diversity in clinical trials. Clin Transl Sci 2023; 16:937-945. [PMID: 36908052 PMCID: PMC10264921 DOI: 10.1111/cts.13513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/16/2023] [Accepted: 03/01/2023] [Indexed: 03/14/2023] Open
Abstract
Diverse representation in clinical trials is crucial to understand the efficacy and safety of drugs in minority groups. This review aims to (1) describe research participants' sex, racial, and ethnic diversity in clinical drug trials and (2) describe the sex distribution of researchers conducting the research. We reviewed all clinical drug trials published in the journals "Clinical Pharmacology and Therapeutics" and "Clinical and Translational Science" in 2000-2001 and 2020-2021 and analyzed the research participants' and researchers' demographics. We compared the race of the research participants with the concurrent race diversity of the reference population in the countries where the research was conducted. We identified 281 articles with 17,639 research participants. Approximately one-third of the research participants were women in both 2000-2001 and 2020-2021. The representation from racial minorities of Black and Asian people increased from 2000-2001 to 2020-2021, but Asian and Native American people are still under-represented in clinical drug trials today. The proportion of female authors increased, but female authors still made up less than 40% of the total number of authors in 2020-2021. In conclusion, men are still over-represented in clinical pharmacology research, and some races are still vastly under-represented. Furthermore, although the proportion of female authors increased with time, they are still under-represented as first and last authors.
Collapse
Affiliation(s)
- Julie Bøttern
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Tore Bjerregaard Stage
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
- Department of PharmacologyOdense University HospitalOdenseDenmark
| | - Ann‐Cathrine Dalgård Dunvald
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| |
Collapse
|
24
|
Rodriguez DK, Hewage SA, Periyakoil VS. Factors affecting the recruitment of Hispanic/Latinx American older adults in clinical trials in the United States: A scoping review. J Am Geriatr Soc 2023; 71:1974-1991. [PMID: 37013348 PMCID: PMC10258132 DOI: 10.1111/jgs.18264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/21/2022] [Accepted: 01/02/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Participation of Hispanic/Latinx American older adults (HLAOA) in clinical trials is fundamental to health equity in aging research. However, information on strategies for the successful recruitment of this population in clinical trials is limited. DESIGN This scoping review aims to identify hindering and facilitating factors that impact the recruitment of HLAOA in clinical trials in the United States. METHODS Two databases (PubMed, EMBASE) were searched for original research articles from inception until March 2022 reporting on factors that engaged HLAoa (≥65) in clinical trials. One thousand and thirteen studies were scrutinized to identify 31 eligible articles. RESULTS Most articles were from cancer clinical trials (14 studies). Hindering factors that impacted the recruitment of HLAoa in clinical trials were related to (i) study design and logistics challenges, (ii) challenges imposed by social determinants of health, (iii) communication barriers, and (iv) patients' mistrust, and (v) family issues. Facilitating factors include (i) effective modes of outreach, (ii) strategic clinical trial design, (iii) incorporating culturally-respectful approaches that are tailored to the participants' sociocultural background, and (iv) bridging language barriers. CONCLUSIONS Successful recruitment of HLAOA into clinical trials requires identifying the study question, co-designing the trial design, implementation, and evaluation in respectful collaboration with the Hispanic/Latinx community with careful attention to their needs and minimizing the study burden on this vulnerable population. Factors identified here may guide researchers to better understand the needs of HLAOA and successfully recruit them into clinical trials, leading to more equitable research that increases their representation in clinical research.
Collapse
Affiliation(s)
- Dulce K Rodriguez
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
| | - Sumali A Hewage
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
| | - Vyjeyanthi S Periyakoil
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
- Veterans Affairs Palo Alto Health Care Center, Palo Alto, California, USA
| |
Collapse
|
25
|
Yousefi Nooraie R, Dadgostar P, Roman G, Cullen JP, Bennett NM. Mapping the distribution of health equity research and practice across a university: a network analysis. J Clin Transl Sci 2023; 7:e142. [PMID: 37396810 PMCID: PMC10308423 DOI: 10.1017/cts.2023.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Health equity research spans various disciplines, crossing formal organizational and departmental barriers and forming invisible communities. This study aimed to map the nomination network of scholars at the University of Rochester Medical Center who were active in racial and ethnic health equity research, education, and social/administrative activities, to identify the predictors of peer recognition. Methods We conducted a snowball survey of faculty members with experience and/or interest in racial and ethnic health equity, nominating peers with relevant expertise. Results Data from a total of 121 individuals (64% doing research on extent and outcomes of racial/ethnic disparities and racism, 48% research on interventions, 55% education, and 50% social/administrative activities) were gathered in six rounds of survey. The overlap between expertise categories was small with coincidence observed between education and social/administrative activities (kappa: 0.27; p < 0.001). Respondents were more likely to nominate someone if both were involved in research (OR: 3.1), if both were involved in education (OR: 1.7), and if both were affiliated with the same department (OR: 3.7). Being involved in health equity research significantly predicted the centrality of an individual in the nomination network, and the most central actors were involved in multiple expertise categories. Conclusions Compared with equity researchers, those involved in racial equity social/administrative activities were less likely to be recognized by peers as equity experts.
Collapse
Affiliation(s)
- Reza Yousefi Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
- Clinical and Translational Science Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Porooshat Dadgostar
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Gretchen Roman
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
- Department of Family Medicine, University of Rochester, Rochester, NY, USA
| | - John P. Cullen
- Clinical and Translational Science Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Susan B. Anthony Center, University of Rochester, Rochester, NY, USA
| | - Nancy M. Bennett
- Clinical and Translational Science Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Center for Community Health and Prevention, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
26
|
Egede LE, Ruiz R, Mosley-Johnson E, Aguilar-Gaxiola SA, Corbie GM, Wilkins CH, Vitale A, Boulware LE. Laying the groundwork to make diversity, equity, and inclusion front and center in clinical and translational research. J Clin Transl Sci 2023; 7:e95. [PMID: 37125065 PMCID: PMC10130834 DOI: 10.1017/cts.2023.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/30/2023] [Indexed: 05/02/2023] Open
Affiliation(s)
- Leonard E. Egede
- Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Raquel Ruiz
- Duke University School of Medicine, Durham, NC, USA
| | - Elise Mosley-Johnson
- Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Giselle M. Corbie
- University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | | | - Alfred Vitale
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | | |
Collapse
|
27
|
De Pablo-Moreno JA, Miguel-Batuecas A, de Sancha M, Liras A. The Magic of Proteases: From a Procoagulant and Anticoagulant Factor V to an Equitable Treatment of Its Inherited Deficiency. Int J Mol Sci 2023; 24:ijms24076243. [PMID: 37047215 PMCID: PMC10093859 DOI: 10.3390/ijms24076243] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Proteostasis, i.e., the homeostasis of proteins, responsible for ensuring protein turnover, is regulated by proteases, which also participate in the etiopathogenesis of multiple conditions. The magic of proteases is such that, in blood coagulation, one same molecule, such as coagulation factor V, for example, can perform both a procoagulant and an anticoagulant function as a result of the activity of proteases. However, this magic has an insidious side to it, as it may also prevent the completion of the clinical value chain of factor V deficiency. This value chain encompasses the discovery of knowledge, the transfer of this knowledge, and its translation to clinical practice. In the case of rare and ultra-rare diseases like factor V deficiency, this value chain has not been completed as the knowledge acquisition phase has dragged out over time, holding up the transfer of knowledge to clinical practice. The reason for this is related to the small number of patients afflicted with these conditions. As a result, new indications must be found to make the therapies cost-effective. In the case of factor V, significant research efforts have been directed at developing a recombinant factor V capable of resisting the action of the proteases capable of inactivating this factor. This is where bioethics and health equity considerations come into the equation.
Collapse
|
28
|
Accelerating diversity, equity, and inclusion goals: a qualitative assessment from the lens of scientists at the 2020 Clinical Translational Science Awards Annual Meeting. J Clin Transl Sci 2023; 7:e35. [PMID: 36845307 PMCID: PMC9947603 DOI: 10.1017/cts.2022.516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/06/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Participants in the leadership breakout session at the Clinical Translational Science Awards (CTSA) virtual 2020 conference discussed and ranked six recommendations in terms of feasibility, impact, and priority for advancing Diversity, Equity, and Inclusion (DEI) efforts to elevate underrepresented populations to leadership positions in CTSAs and their broader institutions. A thematic analysis of chat and polling data identified challenges and opportunities to achieve DEI goals, with the three most promising recommendations as: cross-institutional Principal Investigator (P.I.) action-learning workgroups, transparent policies for recruiting and promoting underrepresented minorities (URM) leadership, and a clear succession plan to nurture and elevate URM leaders. Suggestions are made to improve DEI in CTSA leadership and allow for greater representation in the translational science field.
Collapse
|
29
|
DEIA is essential to advance the goals of translational science: Perspectives from NCATS. J Clin Transl Sci 2023; 7:e33. [PMID: 36845315 PMCID: PMC9947606 DOI: 10.1017/cts.2022.482] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
The National Center for Advancing Translational Science (NCATS) seeks to improve upon the translational process to advance research and treatment across all diseases and conditions and bring these interventions to all who need them. Addressing the racial/ethnic health disparities and health inequities that persist in screening, diagnosis, treatment, and health outcomes (e.g., morbidity, mortality) is central to NCATS' mission to deliver more interventions to all people more quickly. Working toward this goal will require enhancing diversity, equity, inclusion, and accessibility (DEIA) in the translational workforce and in research conducted across the translational continuum, to support health equity. This paper discusses how aspects of DEIA are integral to the mission of translational science (TS). It describes recent NIH and NCATS efforts to advance DEIA in the TS workforce and in the research we support. Additionally, NCATS is developing approaches to apply a lens of DEIA in its activities and research - with relevance to the activities of the TS community - and will elucidate these approaches through related examples of NCATS-led, partnered, and supported activities, working toward the Center's goal of bringing more treatments to all people more quickly.
Collapse
|
30
|
Demographic composition of National Institutes of Health Clinical and Translational Science Awards (CTSA) Program principal investigators, scholars, and trainees. J Clin Transl Sci 2023; 7:e19. [PMID: 36755537 PMCID: PMC9879887 DOI: 10.1017/cts.2022.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/14/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
Little has been published on the demographic composition of the clinical and translational science research workforce within the Clinical and Translational Science Awards (CTSA) Program despite the well-documented need for greater diversity in the biomedical research workforce. Analyses of workforce demographic reveal that women and members of underrepresented groups remain persistently underrepresented in the CTSA hub and training components principal investigators. In contrast, in the CTSA Program career development and training programs, females have greater representation as participants, and non-Whites were better represented in training programs.
Collapse
|
31
|
Casey S, Siebert-Evenstone A, Brasier AR. Win-win interactions: Results and implications of a user needs assessment of clinical and translational scientists. J Clin Transl Sci 2023; 7:e73. [PMID: 37008601 PMCID: PMC10052438 DOI: 10.1017/cts.2023.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/23/2022] [Accepted: 01/10/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction This study describes a needs assessment of clinical and translational research (CTR) scientists at a large, distributed, School of Medicine within a public university and affiliated clinics. Method We performed an Exploratory Conversion Mixed-Methods analysis using a quantitative survey and qualitative interviews with CTR scientists across the training continuum, from early-career scholars, mid-career mentors, and senior administrators at the University of Wisconsin and Marshfield Clinics. Qualitative findings were confirmed using epistemic network analysis (ENA). A survey was distributed to CTR scientists in training. Results Analyses supported that early-career and senior-career scientists have unique needs. Scientists who identified as non-White or female reported needs that differed from White male scientists. Scientists expressed the needs for educational training in CTR, for institutional support of career development, and trainings for building stronger relationships with community stakeholders. The tension between meeting tenure clocks and building deep community connections was particularly meaningful for scholars who identified as under-represented, including based on race, gender, and discipline. Conclusions This study yielded clear differences in support needs between scientists based upon their years in research and diversity of identities. The validation of qualitative findings, through quantification with ENA, enables robust identification of unique needs of CTR investigators. It is critically important to the future of CTR that scientists are provided with supports throughout the career. Delivery of that support in efficient and timely ways improves scientific outcomes. Advocacy at the level of the institution for under-represented scientists is of utmost importance.
Collapse
Affiliation(s)
- Shannon Casey
- Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Allan R. Brasier
- Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin–Madison, School of Medicine and Public Health, Madison, WI, USA
| |
Collapse
|
32
|
Duong J, McIntosh S, Attia J, Michener JL, Cottler LB, Aguilar-Gaxiola SA. Attitudes towards diversity, equity, and inclusion across the CTSA Programs: Strong but not uniform support and commitment. J Clin Transl Sci 2023; 7:e66. [PMID: 37008605 PMCID: PMC10052433 DOI: 10.1017/cts.2022.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 02/10/2023] Open
Abstract
Background This study describes attitudes towards diversity, equity, and inclusion (DEI) among members of the Clinical and Translational Science Awards (CTSA) Program. It also explores associations between program members' roles and their perceived importance of and commitment to improving DEI and assesses the link between perceived importance of and commitment to improving DEI. Lastly, it ascertains barriers and priorities concerning health equity research, workforce development, CTSA consortium leadership, and clinical trials participation among respondents. Methods A survey was administered to registrants of the virtual CTSA Program 2020 Fall Meeting. Respondents reported their roles, perceived importance of and commitment to improving DEI. Bivariate cross-tabulations and structural equation modeling examined associations between respondents' roles, perceived importance of DEI, and commitment to improving DEI. Grounded theory was used to code and analyze open-ended questions. Results Among 796 registrants, 231 individuals completed the survey. DEI was "extremely important" among 72.7 percent of respondents and lowest among UL1 PIs (66.7%). Being "extremely committed" to improving DEI was reported by 56.3 percent of respondents and lowest among "other staff" (49.6%). Perceived importance of DEI was positively associated with commitment to improve DEI. Institutional and CTSA Commitment, Support, and Prioritization of DEI represented a key theme for improving DEI among respondents. Conclusion Clinical and translational science organizations must take bold steps to transform individual perceptions of DEI into commitment and commitment into action. Institutions must set visionary objectives spanning leadership, training, research, and clinical trials research to meet the promise and benefits of a diverse NIH-supported workforce.
Collapse
Affiliation(s)
- Jeffrey Duong
- Center for Reducing Health Disparities, University of California – Davis School of Medicine, Sacramento, CA, USA
| | - Scott McIntosh
- Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Jacqueline Attia
- Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - J. Lloyd Michener
- Department of Family Medicine & Community Health, Duke School of Medicine, Durham, NC, USA
| | - Linda B. Cottler
- Department of Epidemiology, Colleges of Public Health and Health Professions and Medicine, University of Florida, Gainesville, FL, USA
| | - Sergio A. Aguilar-Gaxiola
- Center for Reducing Health Disparities, University of California – Davis School of Medicine, Sacramento, CA, USA
- Clinical and Translational Science Center, Department of Internal Medicine, School of Medicine, Sacramento, CA, USA
| |
Collapse
|
33
|
Feasibility, impact, and priority of key strategies to enhance diverse and inclusive training programs in clinical and translational research: A mixed methods study. J Clin Transl Sci 2023; 7:e16. [PMID: 36721402 PMCID: PMC9884544 DOI: 10.1017/cts.2022.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 02/03/2023] Open
Abstract
Background Enhancing diversity in the scientific workforce is a long-standing issue. This study uses mixed methods to understand the feasibility, impact, and priority of six key strategies to promote diverse and inclusive training and contextualize the six key strategies across Clinical and Translational Science Awards (CTSAs) Program Institutions. Methods Four breakout sessions were held at the NCATS 2020 CTSA Program annual meeting focused on diversity, equity, and inclusion (DEI) efforts. This paper focuses on the breakout session for Enhancing DEI in Translational Science Training Programs. Data were analyzed using a mixed methods convergent approach. The quantitative strand includes the online polling results. The qualitative strand includes the breakout session and the chat box in response to the training presentation. Results Across feasibility, impact, and priority questions, prioritizing representation ranked number 1. Building partnerships ranked number 2 in feasibility and priority, while making it personal ranked number 2 for impact. Across each strategy, rankings supported the qualitative data findings in feasibility through shared experiences, impact in the ability to increase DEI, and priority rankings in comparison to the other strategies. No divergence was found across quantitative and qualitative data findings. Conclusion Findings provide robust support for prioritizing representation as a number one strategy to focus on in training programs. Specifically, this strategy can be operationalized through integration of community representation, diversity advocates, and adopting a holistic approach to recruiting a diverse cadre of scholars into translational science training programs at the national level across CTSAs.
Collapse
|
34
|
Diversity and transparency in gynecologic oncology clinical trials. Cancer Causes Control 2023; 34:133-140. [PMID: 36284031 DOI: 10.1007/s10552-022-01646-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/12/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE Clinical trials advance the standard of care for patients. Patients enrolled in trials should represent the population who would benefit from the intervention in clinical practice. The aim of this study was to assess whether clinical trials enrolling patients with gynecologic cancers report racial and ethnic participant composition and to examine the level of diversity in clinical trials. METHODS Using ClinicalTrials.gov, we identified clinical trials enrolling patients with ovarian, uterine/endometrial, cervical, vaginal, and vulvar cancers from 1988 to 2019. Race and ethnicity data were extracted from participant demographics. Descriptive statistics on race, ethnicity, cancer type, location, study status, and sponsor type were calculated. Among trials which reported race and/or ethnicity, sub-analyses were performed on composition of race and ethnicity by funding source, location, and completed study status. RESULTS A total of 1,882 trials met inclusion criteria; only 179 trials (9.5%) reported race information. Of these, the racial distribution of enrollees was 66.9% White, 8.6% Asian, 8.5% Black/African American, 0.4% Indian/Alaskan Native, 0.1% Native Hawaiian/Pacific Islander, 1.0% more than one race, and 14.5% unknown. Only 100 (5.3%) trials reported ethnicity. Except for trials enrolling patients with cervical cancer which enrolled 65.2% White and 62.1% Non-Hispanic/Latino/a patients, enrollees in trials for other gynecologic cancers were over 80% White and 88% Non-Hispanic/Latino/a. Industry funded trials enrolled higher proportions of White (68.4%) participants than non-industry funded trials (57.5%). Domestic trials report race (11.5%) and ethnicity (7.6%) at higher rates than international trials (6.9% and 2.3%, respectively). Reporting of race (1.7% vs. 13.9%) and ethnicity (1.7% vs. 11.1%) has increased over time for patients enrolled in 2000 vs. 2018. CONCLUSION Less than 10% of trials enrolling patients with gynecologic malignancies report racial/ethnic participant composition on ClinicalTrials.gov. Accurate reporting of participant race/ethnicity is imperative to ensuring minority representation in clinical trials.
Collapse
|
35
|
Cunningham-Erves J, Joosten Y, Kusnoor SV, Mayers SA, Ichimura J, Dunkel L, Israel TL, Ray D, Stroud M, Harris PA, Wilkins CH. A community-informed recruitment plan template to increase recruitment of racial and ethnic groups historically excluded and underrepresented in clinical research. Contemp Clin Trials 2023; 125:107064. [PMID: 36572240 PMCID: PMC9926351 DOI: 10.1016/j.cct.2022.107064] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Engaging communities in research planning and implementation can enhance recruitment and retention (R&R) of racial and ethnic groups historically excluded and underrepresented in clinical research; however, most studies do not use community-informed approaches. This paper describes the formative research process used to design a Community-Informed Recruitment Plan Template for racial and ethnic groups historically excluded and underrepresented in clinical research. METHODS Using an existing R&R template as a starting point, we iteratively developed and refined the community-informed template through a 3-phase process to achieve cultural-appropriateness. Phase 1 included a literature review, 34 community engagement (CE) studios to review recommendations, community advisory board (CAB) review, and survey data from minority recruitment experts. Phase 2 involved integration of content into existing R&R template. Phase 3 was a final review and revision using input of the CAB and researchers' panel. Survey data collected in Phase 1 were analyzed using descriptives (i.e., frequencies and percentages). Open-ended survey responses were analyzed using inductive, qualitative thematic analysis. RESULTS The final 8-section template can help develop effective grant or proposal language where study R&R plans are requested. They include: 1) Recruitment Strategy; 2) A Stakeholder Communication Plan; 3) Evidence of Recruitment Feasibility; 4) Recruitment and Retention Team; 5) Recruitment and Retention Methods; 6) Recruitment and Retention Timeline; 7) Evaluation; and 8) Budget. CONCLUSIONS Incorporating multiple perspectives into this formative research process enhances the cultural appropriateness of this community-informed R&R template to help research teams achieve R&R goals for individuals historically excluded and underrepresented in clinical research.
Collapse
Affiliation(s)
| | - Yvonne Joosten
- Vanderbilt Institute for Medicine and Public Health, Nashville, TN, USA
| | - Sheila V Kusnoor
- Center for Knowledge Management, Strategy and Innovation, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Stephanie A Mayers
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jabari Ichimura
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leah Dunkel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tiffany L Israel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Devan Ray
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mary Stroud
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul A Harris
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Consuelo H Wilkins
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
36
|
Barrett NJ, Boehmer L, Schrag J, Benson AB, Green S, Hamroun-Yazid L, Howson A, Matin K, Oyer RA, Pierce L, Jeames SE, Winkfield K, Yang ES, Zwicker V, Bruinooge S, Hurley P, Williams JH, Guerra CE. An Assessment of the Feasibility and Utility of an ACCC-ASCO Implicit Bias Training Program to Enhance Racial and Ethnic Diversity in Cancer Clinical Trials. JCO Oncol Pract 2023; 19:e570-e580. [PMID: 36630671 DOI: 10.1200/op.22.00378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Cancer trial participants do not reflect the racial and ethnic diversity in the population of people with cancer in the United States. As a result of multiple system-, patient-, and provider-level factors, including implicit bias, cancer clinical trials are not consistently offered to all potentially eligible patients. MATERIALS AND METHODS ASCO and ACCC evaluated the utility (pre- and post-test knowledge changes) and feasibility (completion rates, curriculum satisfaction metrics, survey questions, and interviews) of a customized online training program combined with facilitated peer-to-peer discussion designed to help research teams identify their own implicit biases and develop strategies to mitigate them. Discussion focused on (1) specific elements of the training modules; (2) how to apply lessons learned; and (3) key considerations for developing a facilitation guide to support peer-to-peer discussions in cancer clinical research settings. We evaluated discussion via a qualitative assessment. RESULTS Participant completion rate was high: 49 of 50 participating cancer programs completed training; 126 of 129 participating individuals completed the training (98% response rate); and 119 completed the training and evaluations (92% response rate). Training increased the mean percentage change in knowledge scores by 19%-45% across key concepts (eg, causes of health disparities) and increased the mean percentage change in knowledge scores by 10%-31% about strategies/actions to address implicit bias and diversity concerns in cancer clinical trials. Knowledge increases were sustained at 6 weeks. Qualitative evaluation validated the utility and feasibility of facilitated peer-to-peer discussion. CONCLUSION The pilot implementation of the training program demonstrated excellent utility and feasibility. Our evaluation affirms that an online training designed to raise awareness about implicit bias and develop strategies to mitigate biases among cancer research teams is feasible and can be readily implemented in cancer research settings.
Collapse
Affiliation(s)
- Nadine J Barrett
- Duke Clinical and Translational Science Institute and Duke Cancer Institute, Durham, NC
| | - Leigh Boehmer
- Association of Community Cancer Centers, Rockville, MD
| | | | - Al B Benson
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Sybil Green
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | - Randall A Oyer
- Penn Medicine Lancaster General Health Ann B Barshinger Cancer Institute, Lancaster, PA
| | | | | | - Karen Winkfield
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN
| | - Eddy S Yang
- O'Neal Comprehensive Cancer Center at University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | | | - Carmen E Guerra
- University of Pennsylvania Raymond and Ruth Perelman School of Medicine, Philadelphia, PA
| |
Collapse
|
37
|
Bentley-Edwards KL, Jordan Fleming P, Doherty IA, Whicker DR, Mervin-Blake S, Barrett NJ. The 5Ws of Racial Equity in Research: A Framework for Applying a Racial Equity Lens Throughout the Research Process. Health Equity 2022; 6:917-921. [PMID: 36636118 PMCID: PMC9811832 DOI: 10.1089/heq.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
Ensuring equity in research is a critical step in advancing health equity. In this perspective, the authors introduce a guiding framework for advancing racial equity in research processes, environments, and among the research workforce, the 5Ws of Racial Equity in Research. Centering their discussion on the 5Ws: Who, What, When, Where, and Why, they use historical and contemporary examples of research inequities to demonstrate how these five simple questions can encourage open discussion and proactive planning for equity in research. They close with an acknowledgment of the framework's broad utility and a researcher-directed call to action.
Collapse
Affiliation(s)
- Keisha L. Bentley-Edwards
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Samuel DuBois Cook Center on Social Equity, Duke University, Durham, North Carolina, USA.,Center for Equity in Research, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA.,Address correspondence to: Keisha L. Bentley-Edwards, PhD, Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
| | - Patrice Jordan Fleming
- Center for Equity in Research, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA.,Community Engaged Research Initiative, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA
| | - Irene A. Doherty
- Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University, Durham, North Carolina, USA.,RCMI Center for Health Disparities Research, North Carolina Central University, Durham, North Carolina, USA
| | - Dane R. Whicker
- Center for Equity in Research, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sabrena Mervin-Blake
- Center for Equity in Research, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA.,Community Engaged Research Initiative, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA
| | - Nadine J. Barrett
- Center for Equity in Research, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina, USA.,Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| |
Collapse
|
38
|
Carter-Edwards L, Hightower M, Schick V, Nguyen T, Hidalgo B, Cacari Stone L, Laird R, Ossip D, Rubio M, ElShourbagy Ferreira S, Carrasquillo O. The CTSA Diversity, Equity, Inclusion, and Accessibility (DEIA) Task Force's recommendations for the CTSA program consortium. J Clin Transl Sci 2022; 7:e41. [PMID: 36845311 PMCID: PMC9947599 DOI: 10.1017/cts.2022.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022] Open
Abstract
The Clinical and Translational Science Award (CTSA) Program recognizes that advancing diversity, equity, inclusion, and accessibility (DEIA) requires moving beyond statements of commitment to transformative actions. In 2021, the CTSA Program created a Task Force (TF) to initiate work in support of structural and transformational initiatives that advance DEIA for the consortium and its individual hubs. We describe the process of forming the expertise-driven (DEIA) TF and our activities to date. We 1) developed and adopted the DEIA Learning Systems Framework to guide our approach; 2) defined a set of recommendations across four focus areas (Institutional; Programmatic; Community-Centered; and Social, Cultural, Environmental); and 3) designed and disseminated a survey to capture the CTSA Program's baseline demographic, community, infrastructural, and leadership diversity. The CTSA Consortium also elevated the TF to a standing Committee to extend our understanding, development, and implementation of DEIA approaches to translational and clinical science. These initial steps provide a foundation for collectively fostering environment that support DEIA across the research continuum.
Collapse
Affiliation(s)
- Lori Carter-Edwards
- The North Carolina Translational and Clinical Sciences Institute (NC TraCS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Maia Hightower
- Utah Clinical and Translational Science Institute, University of Utah, Salt Lake City, UT, USA
| | - Vanessa Schick
- Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tung Nguyen
- University of California San Francisco Clinical and Translational Science Institute, San Francisco, CA, USA
| | - Bertha Hidalgo
- Center for Clinical and Translational Science, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lisa Cacari Stone
- University of New Mexico Clinical and Translational Sciences Center, Albuquerque, NM, USA
| | - Rebecca Laird
- Center for Leading Innovation and Collaboration (CLIC), University of Rochester Clinical Translational Science Institute, Rochester, NY, USA
| | - Deborah Ossip
- Center for Leading Innovation and Collaboration (CLIC), University of Rochester Clinical Translational Science Institute, Rochester, NY, USA
| | - Mercedes Rubio
- Division of Training, Workforce Development, and Diversity, National Institute of General Medicical Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Sanae ElShourbagy Ferreira
- Clinical and Translational Science Awards Program Branch, National Center for Advancing Translational Science, National Institutes of Health, Bethesda, MD, USA
| | - Olveen Carrasquillo
- University of Miami Clinical and Translational Science Institute, Miami, FL, USA
| |
Collapse
|
39
|
Hanlon AL, Lozano AJ, Prakash S, Bezar EB, Ambrosius WT, Brock G, Desai M, Pollock BH, Sammel MD, Spratt H, Welty LJ, Pomann G. A comprehensive survey of collaborative biostatistics units in academic health centers. Stat (Int Stat Inst) 2022. [PMID: 37502567 PMCID: PMC10369852 DOI: 10.1002/sta4.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The organizational structures of collaborative biostatistics units in academic health centers (AHCs) in the United States and their important contributions to research are an evolving and active area of discussion and inquiry. Collaborative biostatistics units may serve as a centralized resource to investigators across various disciplines or as shared infrastructure for investigators within a discipline (e.g., cancer), or a combination of both. The characteristics of such units vary greatly, and there has been no comprehensive review of their organizational structures described in the literature to date. This manuscript summarizes the current infrastructure of such units using responses from 129 leaders. Most leaders were over 45 years old, held doctoral degrees, and were on a 12-month appointment. Over half were tenured or on a tenure track and held primary appointments in a school of medicine. Career advancement metrics most important included being funded as co-investigator on NIH grants and being either first or second author on peer-reviewed publications. Team composition was diverse in terms of expertise and training, and funding sources were typically hybrid. These results provide a benchmark for collaboration models and evaluation and may be used by institutional administrators as they build, evaluate, or restructure current collaborative quantitative support infrastructure.
Collapse
Affiliation(s)
- Alexandra L. Hanlon
- Center for Biostatistics and Health Data Science, Department of Statistics Virginia Polytechnic Institute and State University Roanoke Virginia USA
| | - Alicia J. Lozano
- Center for Biostatistics and Health Data Science, Department of Statistics Virginia Polytechnic Institute and State University Roanoke Virginia USA
| | - Swathi Prakash
- Center for Biostatistics and Health Data Science, Department of Statistics Virginia Polytechnic Institute and State University Roanoke Virginia USA
| | - Emily B. Bezar
- Center for Biostatistics and Health Data Science, Department of Statistics Virginia Polytechnic Institute and State University Roanoke Virginia USA
| | - Walter T. Ambrosius
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest University School of Medicine Winston‐Salem North Carolina USA
| | - Guy Brock
- Department of Biomedical Informatics Ohio State University Columbus Ohio USA
| | - Manisha Desai
- Quantitative Sciences Unit, Stanford Medicine Stanford University Stanford California USA
| | - Brad H. Pollock
- Department of Public Health Sciences University of California Davis Davis California USA
| | - Mary D. Sammel
- Center for Innovative Design & Analysis, Department of Biostatistics & Informatics, School of Public Health University of Colorado Denver Denver Colorado USA
| | - Heidi Spratt
- Department of Biostatistics and Data Science, School of Public and Population Health University of Texas Medical Branch Galveston Texas USA
| | - Leah J. Welty
- Feinberg School of Medicine Northwestern University Evanston Illinois USA
| | - Gina‐Maria Pomann
- Department of Biostatistics and Bioinformatics Duke University School of Medicine Durham North Carolina USA
| |
Collapse
|
40
|
Silberberg M. Research translation: A pathway for health inequity. Clin Transl Sci 2022; 16:179-183. [PMID: 36325944 PMCID: PMC9926067 DOI: 10.1111/cts.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/14/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
In a context of social inequity, research translation naturally furthers health inequity. As Fundamental Cause Theory (FCT) explains-and an associated empirical literature illustrates-those with more resources benefit earlier and more from scientific innovation than those with fewer resources. Therefore, research translation of its own course creates and widens health disparities based on socioeconomic status and race/ethnicity. Yet, the conversation about research translation has yet to center this critical reality, undermining our efforts to address heath inequity. Moving toward sustainable health equity requires that we build the evidence base for, prioritize, and institutionalize translation approaches that center the needs and assets of low-resource populations (with community engagement helping toward that end). However, even the impact of that approach will be limited if we as a society do not mobilize knowledge to address social inequity and the many ways in which it shapes health. The health research community should engage the FCT paradigm to think critically about resource allocation among different kinds of research and action. Moreover, in our contributions to discussions about the road to health equity, we must be forthcoming about the reality FCT describes and the limitations it indicates for achieving health equity through translation of biomedical, clinical, health services, and health behavior research alone.
Collapse
Affiliation(s)
- Mina Silberberg
- Department of Family Medicine and Community Health, Community Engaged Research Initiative, CTSI, Global Health Institute, Margolis Center for Health Policy, Department of Head and Neck Surgery & Communication SciencesDuke UniversityNorth CarolinaDurhamUSA
| |
Collapse
|
41
|
Oetzel J, Sika-Paotonu D, Penetito-Hemara D, Henry A. Healthier Lives Implementation Research Network for Māori and Pacific community health providers in Aotearoa New Zealand: a study protocol with an observational mixed methods design. Implement Sci Commun 2022; 3:122. [PMID: 36419125 PMCID: PMC9686062 DOI: 10.1186/s43058-022-00373-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Despite incremental gains in the Aotearoa New Zealand health sector, Māori and Pacific peoples still experience poorer health outcomes than non-Māori and non-Pacific. Access to the latest research and innovation is critical to improving and addressing health outcomes and health inequities in particular. However, there are numerous challenges to translating research into practice including that there is currently no known a specific infrastructure in Aotearoa New Zealand to facilitate this process. The aim of the project is to develop a network of community providers, researchers and health systems representatives that can help facilitate the implementation of novel and innovative programmes and products that help to meet the health needs of Māori and Pacific communities. METHODS This project has three stages, one of which has been completed. In Stage 1, we engaged with key leaders of organisations from various components in the health system through a co-design process to identify parameters and infrastructure of the network. In Stage 2, we propose to construct the network involving approximately 20-30 community providers (and other affiliated researchers and health system representatives) and refine its parameters through an additional co-design process. Additionally, we will use a mixed methods research design using survey and interviews to identify perceived implementation needs, facilitators and barriers to help inform the work in the third stage. In Stage 3, we will support the active implementation of evidence-based programmes with a smaller number of providers (approximately four to eight community providers depending on the complexity of the implementation). Mixed methods research will be conducted to understand facilitators and barriers to implementation processes and outcomes. DISCUSSION The proposed network infrastructure is an equity-oriented strategy focused on building capacity through a strength-based approach that can help address inequities over time. Our "proof-of-concept" study will not be able to change inequities in that time period given its relatively small scale and time period, but it should set the foundation for continued equity-oriented work.
Collapse
Affiliation(s)
- John Oetzel
- University of Waikato, Hamilton, New Zealand
| | | | | | - Akarere Henry
- South Waikato Pacific Islands Community Services, Tokoroa, New Zealand
| |
Collapse
|
42
|
Folayan MO, Conway M, Russo C, Diniz N, Jafta LP, Sam-Agudu NA, Bernays S, Santana VM, Epps C, Turner MA. Health Equity in Pediatric Drug Development: Translating Aspiration into Operation. Ther Innov Regul Sci 2022; 56:991-1003. [PMID: 35596108 PMCID: PMC9122543 DOI: 10.1007/s43441-022-00410-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/07/2022] [Indexed: 01/01/2023]
Abstract
The concept of health equity-the attainment of the highest possible level of health for all members of society-requires equitable access to all aspects of healthcare, including pediatric drug development. However, many communities are under-represented in pediatric drug development programs. Barriers to participation include geographic, economic, racial/ethnic bias, legal, cultural, linguistic, and other factors. While there is no "one size fits all" approach to addressing these barriers, community engagement and collaboration is recognized by the Centers for Disease Control, the World Health Organization, and other global health organizations as a cornerstone for building a more equitable healthcare system. In this article, we will present case studies of stakeholder and community engagement in clinical research for rare diseases and other areas of healthcare, as examples of strategies and practices for actively involving under-represented communities and fostering their participation in pediatric drug development programs. These studies may serve as templates for facilitating equity in pediatric drug development from aspiration into operation.
Collapse
Affiliation(s)
| | | | - Carolyn Russo
- Department of Hematology, St. Jude Children's Research Hospital and Comprehensive Cancer Center, Memphis, TN, USA
| | - Nilza Diniz
- Biology Department, Biological Sciences Center, State University of Londrina, Londrina, PR, 86057-970, Brazil
| | | | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Pediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Sarah Bernays
- School of Public Health, University of Sydney, Sydney, Australia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Victor M Santana
- Departments of Oncology and Global Pediatric Medicine, St. Jude Children's Research Hospital and Comprehensive Cancer Center, Memphis, TN, USA
| | - Carla Epps
- Office of Pediatric Therapeutics, Food and Drug Administration, Silver Spring, MD, USA
| | - Mark A Turner
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Health Partners, Liverpool, UK.
- Neonatal Unit, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK.
| |
Collapse
|
43
|
Faupel‐Badger JM, Vogel AL, Austin CP, Rutter JL. Advancing translational science education. Clin Transl Sci 2022; 15:2555-2566. [PMID: 36045637 PMCID: PMC9652430 DOI: 10.1111/cts.13390] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/11/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023] Open
Abstract
In this communication, the authors offer considerations for how the scientific community can capitalize on decades of translational science advances and experiential knowledge to develop new education opportunities for a diverse and highly skilled translational science workforce. Continued advancement of the field of translational science will require new education approaches that distill key concepts in translational science from past and ongoing research initiatives and teach this foundational knowledge to current and future translational scientists. These key concepts include generalizable scientific and operational principles to guide translational science, as well as evidence-informed practices. Inspired by this approach, the National Center for Advancing Translational Sciences (NCATS) has developed an initial set of guiding principles for translational science generated via case studies of multiple highly successful translational science initiatives, and is now teaching them via new education activities that aim to reach a broad scientific audience interested in translational science. Our goal with this review is to prompt continued conversation with the translational science community regarding capitalizing on our collective translational science knowledge to advance core content for translational science education and disseminating this content to a broad range of scientific audiences.
Collapse
Affiliation(s)
- Jessica M. Faupel‐Badger
- National Institutes of HealthNational Center for Advancing Translational SciencesBethesdaMarylandUSA
| | - Amanda L. Vogel
- National Institutes of HealthNational Center for Advancing Translational SciencesBethesdaMarylandUSA
| | | | - Joni L. Rutter
- National Institutes of HealthNational Center for Advancing Translational SciencesBethesdaMarylandUSA
| |
Collapse
|
44
|
Williams JS, Walker RJ, Burgess KM, Shay LA, Schmidt S, Tsevat J, Campbell JA, Dawson AZ, Ozieh MN, Phillips SA, Egede LE. Mentoring strategies to support diversity in research-focused junior faculty: A scoping review. J Clin Transl Sci 2022; 7:e21. [PMID: 36755542 PMCID: PMC9879913 DOI: 10.1017/cts.2022.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The purpose of this scoping review is two-fold: to assess the literature that quantitatively measures outcomes of mentorship programs designed to support research-focused junior faculty and to identify mentoring strategies that promote diversity within academic medicine mentoring programs. Methods Studies were identified by searching Medline using MESH terms for mentoring and academic medicine. Eligibility criteria included studies focused on junior faculty in research-focused positions, receiving mentorship, in an academic medical center in the USA, with outcomes collected to measure career success (career trajectory, career satisfaction, quality of life, research productivity, leadership positions). Data were abstracted using a standardized data collection form, and best practices were summarized. Results Search terms resulted in 1,842 articles for title and abstract review, with 27 manuscripts meeting inclusion criteria. Two studies focused specifically on women, and four studies focused on junior faculty from racial/ethnic backgrounds underrepresented in medicine. From the initial search, few studies were designed to specifically increase diversity or capture outcomes relevant to promotion within academic medicine. Of those which did, most studies captured the impact on research productivity and career satisfaction. Traditional one-on-one mentorship, structured peer mentorship facilitated by a senior mentor, and peer mentorship in combination with one-on-one mentorship were found to be effective strategies to facilitate research productivity. Conclusion Efforts are needed at the mentee, mentor, and institutional level to provide mentorship to diverse junior faculty on research competencies and career trajectory, create a sense of belonging, and connect junior faculty with institutional resources to support career success.
Collapse
Affiliation(s)
- Joni S. Williams
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rebekah J. Walker
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kaylin M. Burgess
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - L. Aubree Shay
- UTHealth School of Public Health in San Antonio, San Antonio, TX, USA
| | - Susanne Schmidt
- Department of Population Health Sciences, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Joel Tsevat
- ReACH Center and Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jennifer A. Campbell
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Aprill Z. Dawson
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mukoso N. Ozieh
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine, Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine, Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA
| | - Shane A. Phillips
- Department of Physical Therapy, College of Applied Health Sciences, Center for Clinical and Translational Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Leonard E. Egede
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
45
|
Tuttle KR, Rangaswami J. SGLT2 inhibitors as the bedrock of therapy for heart failure. Lancet 2022; 400:711-713. [PMID: 36041473 DOI: 10.1016/s0140-6736(22)01584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Katherine R Tuttle
- Providence Medical Research Center, Providence Inland Northwest, Spokane, WA 99204, USA; Nephrology Division and Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Janani Rangaswami
- Nephrology Division, George Washington University School of Medicine, Washington DC, USA
| |
Collapse
|
46
|
Shay LA, Schmidt S, Thurston AJ, Campbell JA, Dawson AZ, Egede LE, Ozieh MN, Phillips SA, Walker RJ, Williams JS, Tsevat J. Advancing diversity, equity, and inclusion within clinical and translational science training programs: A qualitative content analysis of the training breakout session at the national CTSA program meeting. J Clin Transl Sci 2022; 6:e110. [PMID: 36285024 PMCID: PMC9549480 DOI: 10.1017/cts.2022.442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 01/12/2023] Open
Abstract
Background Diversity, equity, and inclusion (DEI) in clinical and translational science (CTS) are paramount to driving innovation and increasing health equity. One important area for improving diversity is among trainees in CTS programs. This paper reports on findings from a special session at the November 2020 Clinical and Translational Science Award (CTSA) national program meeting that focused on advancing diversity and inclusion within CTS training programs. Methods Using qualitative content analysis, we identified approaches brought forth to increase DEI in KL2 career development and other training programs aimed at early-stage CTS investigators, beyond the six strategies put forth to guide the breakout session (prioritizing representation, building partnerships, making it personal, designing program structure, improving through feedback, and winning endorsement). We used an inductive qualitative content analysis approach to identify themes from a transcript of the panel of KL2 program leaders centered on DEI in training programs. Results We identified four themes for advancing DEI within CTS training programs: 1) institutional buy-in; 2) proactive recruitment efforts; 3) an equitable application process; and 4) high-quality, diverse mentorship. Conclusion Implementing these strategies in CTS and other training programs will be an important step for advancing DEI. However, processes need to be established to evaluate the implementation and effectiveness of these strategies through continuous quality improvement, a key component of the CTSA program. Training programs within the CTSA are well-positioned to be leaders in this critical effort to increase the diversity of the scientific workforce.
Collapse
Affiliation(s)
- L. Aubree Shay
- UTHealth School of Public Health in San Antonio, San Antonio, TX, USA
| | - Susanne Schmidt
- Department of Population Health Sciences, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Jennifer A. Campbell
- Department of Medicine, Division of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Aprill Z. Dawson
- Department of Medicine, Division of General Internal Medicine, Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Leonard E. Egede
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mukoso N. Ozieh
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine, Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA
| | - Shane A. Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Rebekah J. Walker
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joni S. Williams
- Department of Medicine, Division of General Internal Medicine, Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joel Tsevat
- ReACH Center and Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| |
Collapse
|
47
|
Ruiz R, Vitale A, Schwartz A, Ossip D, Zand MS, Dozier A, Egede LE. From insights to action: Enriching the clinical and translational research workforce by developing diverse and inclusive career programs. J Clin Transl Sci 2022; 6:e104. [PMID: 36128340 PMCID: PMC9453576 DOI: 10.1017/cts.2022.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
Diversification of the Translational Science workforce is a strategic goal for the National Center for the Advancement of Translational Science (NCATS) program. NCATS has identified the development of translational science education, training, and support for a diverse translational science workforce as key to advancing the growing field of translational science. An annual mixed-methods assessment has been conducted on Common Metrics data submitted by over 60 Clinical & Translational Science Awards (CTSA) programs nationwide and includes metrics addressing recruitment and retention of scientists with particular attention to underrepresented persons and women. This article describes a methodology for the development of From Insights to Action, a resource for guiding program implementation and strategic planning to develop a diverse clinical and translational science workforce. This was informed by the Common Metrics Initiative process and constituted of findings from qualitative interviews of a subset of CTSAs that participated. The dissemination of this guide had several impacts, including providing structural foci for the CTSA Fall 2020 program meeting centered on Diversity, Equity, and Inclusion in translational science; addressing NCATS' goal of workforce diversity; and understanding the number of diverse graduates still engaged in research.
Collapse
Affiliation(s)
- Raquel Ruiz
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Alfred Vitale
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Ann Schwartz
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
| | - Deborah Ossip
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Martin S. Zand
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
- Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY, USA
| | - Ann Dozier
- University of Rochester Clinical and Translational Science Institute, Rochester, NY, USA
- Center for Leading Innovation and Collaboration (CLIC), CTSA Program Coordinating Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Leonard E. Egede
- Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
48
|
Translational Science 22 conference proceedings. J Clin Transl Sci 2022; 6:e98. [PMID: 36003209 PMCID: PMC9393573 DOI: 10.1017/cts.2022.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 01/26/2023] Open
Abstract
The Translational Science TS22 conference in Chicago in April 2022 was the first time post-pandemic that members of the Association of Clinical and Translational Science were able to meet up in person to share scientific advances. Given the remaining level of risk due to COVID-19, the meeting was designed as hybrid allowing virtual participation to some of the presentations. Prior to the meeting, JCTS Junior Editors were invited to report on the plenary sessions of the meeting. The present perspective constitutes a summary of three plenary sessions.
Collapse
|
49
|
Wenger NK, Lloyd-Jones DM, Elkind MSV, Fonarow GC, Warner JJ, Alger HM, Cheng S, Kinzy C, Hall JL, Roger VL. Call to Action for Cardiovascular Disease in Women: Epidemiology, Awareness, Access, and Delivery of Equitable Health Care: A Presidential Advisory From the American Heart Association. Circulation 2022; 145:e1059-e1071. [PMID: 35531777 PMCID: PMC10162504 DOI: 10.1161/cir.0000000000001071] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Addressing the pervasive gaps in knowledge and care delivery to reduce sex-based disparities and achieve equity is fundamental to the American Heart Association's commitment to advancing cardiovascular health for all by 2024. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders around the globe to identify and remove barriers to health care access and quality for women. A concise and current summary of existing data across the areas of risk and prevention, access and delivery of equitable care, and awareness and education provides a framework to consider knowledge gaps and research needs critical toward achieving significant progress for the health and well-being of all women.
Collapse
|
50
|
Enders FT, Golembiewski EH, Orellana MA, DSouza KN, Addani MA, Morrison EJ, Benson JT, Silvano CJ, Pacheco-Spann LM, Balls-Berry JE. Changing the face of academic medicine: an equity action plan for institutions. J Clin Transl Sci 2022; 6:e78. [PMID: 35874036 PMCID: PMC9280456 DOI: 10.1017/cts.2022.408] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/06/2022] Open
Abstract
In recent years, there have been concerted efforts to better recruit, support, and retain diverse faculty, staff, and trainees in academic medicine. However, many institutions lack comprehensive and strategic plans to provide support to retain and recruit individuals from historically underrepresented groups. In this article, we itemize specific mechanisms through which institutions can support diverse individuals with the goal of improving inclusion and belonging in the workforce to better reflect the diversity of the intended patient and research participant population.
Collapse
Affiliation(s)
- Felicity T. Enders
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Minerva A. Orellana
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Karen N. DSouza
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Mohamed A. Addani
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | | | - Joanne T. Benson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Carmen J. Silvano
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | | | | |
Collapse
|